Photopic negative response of full-field electroretinography in patients with different stages of glaucomatous optic neuropathy.
Photopic negative response of full-field electroretinography in patients with different stages of glaucomatous optic neuropathy.
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DOI：
10.1007/s10633-016-9528-z
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发表时间：
2016-02
期刊：
影响因子：
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通讯作者：
Penkala K
中科院分区：
文献类型：
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作者：
Kirkiewicz M;Lubiński W;Penkala K
目的评价正常人与脑卒中患者明视负反应（PhNR）的辨别能力。 对原发性开角型青光眼（POAG）患者50例（90只眼）和健康对照组23例（45只眼）进行了研究。根据欧洲青光眼协会的标准，POAG患者分为三组：早期，中度和晚期青光眼。分析以下测量值：Humphrey视野分析仪的平均缺损（MD），白色视野上的SITA标准24-2白色;扫描激光偏振仪获得的神经纤维指数（NFI）; GDx和PhNR振幅以及PhNR/b波比值。PhNR引起的红色刺激与闪光强度为1.6 cd s/m2的蓝色背景上的25 cd/m2。计算视网膜神经节细胞功能（PhNR）、视网膜敏感度（MD）和结构（NFI）之间的相关性。用标准公式计算PhNR参数的敏感性和特异性。受试者工作特征（ROC）曲线用于确定最佳截止值。曲线下面积（AUC）用于比较PhNR幅度和比值之间的ROC曲线结果。与对照组相比，早期、中度和晚期青光眼组的PhNR振幅和比率显著降低。早期POAG检测青光眼的敏感性和特异性分别为PhNR振幅53.3%和90.0%，PhNR比值60.0%和70.0%，中度POAG检测青光眼的敏感性和特异性分别为PhNR振幅63.3%和80.0%，PhNR比值60.0%和86.7%;晚期POAG的PhNR振幅分别为76.6%和80.0%，PhNR比值分别为90.0%和73.3%。PhNR振幅（0.76-0.86）和PhNR比值（0.78-0.86）的AUC之间无显著差异，p > 0.05。PhNR振幅和比率与SAP测量的MD和GDx获得的NFI显著相关（p < 0.05）。PhNR振幅随着青光眼患者视野缺损的进展而显著降低。PhNR揭示了POAG早、中、晚期视网膜节细胞的功能障碍。PhNR对青光眼患者的检测具有良好的区分能力。PhNR可作为青光眼诊断的一项有用指标。
To evaluate photopic negative response (PhNR) discrimination ability between healthy and glaucomatous patients. Ninety eyes of 50 patients with primary open angle glaucoma (POAG) and 45 eyes of 23 healthy age- and sex-matched controls were investigated. Based on European Glaucoma Society criteria, POAG patients were divided into three groups: early, moderate and advanced glaucoma. Following measurements were analysed: mean defect (MD) from Humphrey Visual Field Analyzer, SITA standard 24-2 white on white perimetry; nerve fibre index (NFI) obtained from scanning laser polarimetry; and GDx and PhNR amplitude and PhNR/b-wave ratio. PhNR was elicited by red stimuli with flash strength of 1.6 cd s/m2 on blue background of 25 cd/m2. Correlations between retinal ganglion cells function (PhNR), retinal sensitivity (MD) and structure (NFI) were calculated. Sensitivity and specificity of PhNR parameters were calculated with standard formulas. Receiver operating characteristic (ROC) curves were used to determine optimal cut-off values. The area under the curve (AUC) was used to compare the ROC curves results between PhNR amplitude and ratio. PhNR amplitude and ratio were significantly reduced in early, moderate and advanced glaucoma groups compared to controls. The sensitivity and specificity to detect glaucoma in early POAG were equal to 53.3 and 90.0 % for PhNR amplitude and 60.0 and 70.0 % for PhNR ratio; in moderate POAG 63.3 and 80.0 % for PhNR amplitude and 60.0 and 86.7 % for PhNR ratio; and in advanced POAG 76.6 and 80.0 % for PhNR amplitude, 90.0 and 73.3 % for PhNR ratio. There were no significant differences between AUC for PhNR amplitude (0.76–0.86) and PhNR ratio (0.78–0.86), p > 0.05. PhNR amplitudes and ratios correlated significantly with MD measured by SAP and NFI obtained from GDx (p < 0.05). PhNR amplitude significantly decreases with advancement of visual field defects in glaucoma patients. PhNR reveals dysfunction of RGCs in early, moderate and advanced stage of POAG. PhNR has good discrimination ability in detecting glaucomatous patients. PhNR might be a useful test in glaucoma diagnosis.