On- and off-response ERGs elicited by sawtooth stimuli in normal subjects and glaucoma patients
On- and off-response ERGs elicited by sawtooth stimuli in normal subjects and glaucoma patients
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DOI：
10.1007/s10633-012-9323-4
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发表时间：
2012-06-01
影响因子：
1.4
通讯作者：
Kremers, Jan
中科院分区：
文献类型：
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作者：
Pangeni, Gobinda;Laemmer, Robert;Kremers, Jan
本研究的目的是测量正常人和青光眼患者对锯齿状刺激的开、关反应及其反应的不对称性。此外，还研究了ERG与其他功能和结构参数之间的相关性。全场刺激是使用以发光二极管(LED)为光源的甘兹菲尔德碗产生的。在100%对比度下，对17例健康人、12例周围性青光眼患者和15例周围性青光眼患者使用4赫兹快速开启和快速关闭锯齿刺激(白光；平均亮度55cd/m(2))记录开启和关闭响应ERG。加入开启和关闭反应来研究反应的不对称性。此外，红色刺激(200cd/m(2))在蓝色背景(10cd/m(2))上诱发闪光ERG。视野缺陷的平均偏差(MD)由标准自动视野计获得。用光谱域光学相干断层扫描(SOCT)测量视网膜神经纤维层厚度(RNFLT)。我们研究了ERG反应幅度、视野平均偏差(MDS)和RNFLT值之间的相关性。ON反应表现为先阴性(N-ON)、后阳性(P-ON)、晚期阳性(LP-ON)和晚期阴性反应(LN-ON)。OFF反应表现为初始阳性(P-OFF)、晚期阳性(LP-OFF)和晚期阴性反应(LN-OFF)。ON和OFF反应的相加表现为初始阳性反应(P-ADD)和晚期阴性反应(LN-ADD)。青光眼患者的ON反应成分(N-ON、P-ON和LN-ON)与对照组比较相似。然而，周围期患者的Lp-On显著升高(p=0.03)。周围组Lp-Off显著升高(P<0.001.0 1)，LN-Off波幅显著降低(P=0.0 2)。周围型患者LN-ADD波幅显著降低(P<0.001)，延迟(P=0.03)。闪光视网膜电图中LN-OFF和LN-ADD成分的波幅与PHNR(LN-OFF：P=0.001；LN-ADD：P<；0.001)和RNFLT(LN-OFF：P=0.006；LN-ADD：P=0.001)显著相关。在青光眼患者中，由锯齿形刺激引起的开反应和非反应ERG及其反应不对称性发生了改变。较晚的组件会受到影响。晚期负性成分的变化与结构和其他功能变化相关。
The aim of this study is to measure the on- and off-responses and their response asymmetries elicited by sawtooth stimuli in normal subjects and glaucoma patients. Furthermore, the correlation between the ERGs and other functional and structural parameters are investigated. Full-field stimuli were produced using a Ganzfeld bowl with Light Emitting Diodes (LEDs) as light sources. On- and off-response ERGs were recorded from 17 healthy subjects, 12 pre-perimetric and 15 perimetric glaucoma patients using 4-Hz luminance rapid-on and rapid-off sawtooth stimuli (white light; mean luminance 55 cd/m(2)) at 100 % contrast. The on- and off-responses were added to study response asymmetries. In addition, flash ERGs were elicited by red stimuli (200 cd/m(2)) on a blue background (10 cd/m(2)). The mean deviations (MD) of the visual field defects were obtained by standard automated perimetry. The retinal nerve fibre layer thickness (RNFLT) was measured with Spectral Domain Optical Coherence Tomography (SOCT). We studied the correlation between ERG response amplitudes, visual field mean deviation (MDs) and RNFLT values. The on-responses showed an initial negative (N-on) followed by a positive (P-on), a late positive (LP-on) and a late negative responses (LN-on). The off-responses showed an initial positive (P-off) a late positive (LP-off) and a late negative response (LN-off). The addition of on- and off-responses revealed an initial positive (P-add) and a late negative response (LN-add). The on-response components (N-on, P-on and LN-on) in the glaucoma patients were relatively similar to those of the control subjects. However, the LP-on was significantly elevated (p = 0.03) in perimetric patients. The LP-off was significantly elevated (p < 0.001), and the amplitude of LN-off was significantly reduced in perimetric patients (p = 0.02). The LN-add amplitude was significantly reduced (p < 0.001) and delayed (p = 0.03) in perimetric patients. The amplitudes of the LN-off and LN-add ERG components were significantly correlated with the PhNR in the flash ERG (LN-off: p = 0.01; LN-add: p < 0.001) and with RNFLT (LN-off: p = 0.006; LN-add: p = 0.001). On- and off-response ERGs and their response asymmetries, elicited by sawtooth stimuli, are altered in the glaucoma patients. The late components are affected. Changes in the late negative components are correlated with structural and other functional changes.