Pattern Electroretinogram in Glaucoma Suspects: New Findings from a Longitudinal Study
Pattern Electroretinogram in Glaucoma Suspects: New Findings from a Longitudinal Study
复制标题
DOI：
10.1167/iovs.10-6381
复制
发表时间：
2011-06-01
影响因子：
4.4
通讯作者：
Bach, Michael
中科院分区：
文献类型：
--
作者：
Bode, Sebastian F. N.;Jehle, Thomas;Bach, Michael
目的.青光眼的早期检测仍然是一个具有挑战性的问题，需要长期的前瞻性研究。图形视网膜电图（PERG）直接反映视网膜神经节细胞功能。通过对高眼压患者进行前瞻性研究，评估PERG的振幅、PERG比率、峰值时间及其变化趋势。本研究纳入了64例眼内压大于25 mm Hg（或≥ 23 mm Hg，伴有其他危险因素）、视野正常、视盘外观正常、视力≥ 0.8的患者的120只眼。平均随访时间为10.3年。分析了每次访视的振幅测量值（15次翻转/s至0.8度检查大小）、PERG比率（0.8度/16度）、峰值时间、视野及其趋势。在研究过程中，根据视野定义，13只眼转化为青光眼。在转换器中，0.8度检查尺寸的振幅、PERG比率和峰值时间显著较低。振幅和PERG比率预测4年前的转换，敏感性/特异性分别为67%/64%和75%/76%。此时，ROC区域已经显著高于PERG比率的机会。转换者和非转换者的趋势比较显示PERG比率存在显著差异;然而，趋势并不能像单次访视测量那样成功预测转换。PERG，尤其是PERG比率，在视野改变发生前4年检测青光眼患者，敏感性/特异性为75%/76%。斜率分析需要多次访问，但在检测转换器方面提供的额外信息很少。（Invest Ophthalmol维斯科学。2011;52：4300-4306）DOI：10.1167/iovs.10-6381
PURPOSE. Early detection of glaucoma remains a challenging problem and needs long-term, prospective studies. The pattern electroretinogram (PERG) directly reflects retinal ganglion cell function. The PERG was evaluated by extending a prospective study of patients with ocular hypertension and evaluated amplitude, PERG ratio, peak time, and trends thereof.METHODS. One hundred twenty eyes of 64 patients with intraocular pressure greater than 25 mm Hg (or >= 23 mm Hg with additional risk factors), normal visual fields, normal optic disc appearance, and visual acuity >= 0.8 were included in the study. Mean follow-up time was 10.3 years. The per-visit measures of amplitude at 15 reversals/s to 0.8 degrees check size, PERG ratio (0.8 degrees/16 degrees), peak time, visual field, and their trends were analyzed.RESULTS. Over the course of the study 13 eyes converted to glaucoma according to a visual field definition. Amplitude to 0.8 degrees check size, PERG ratio, and peak time were significantly lower in converters. Amplitude and PERG ratio predicted conversion 4 years ahead with a sensitivity/specificity of 67%/64% and 75%/76%, respectively. At this time, the ROC area was already significantly above chance for the PERG ratio. Comparison of the trends of converters and nonconverters revealed significant differences in the PERG ratio; however, trends did not predict conversion as successfully as single-visit measures.CONCLUSIONS. The PERG, especially the PERG ratio, detected glaucoma patients 4 years before visual field changes occurred, with a sensitivity/specificity of 75%/76%. Slope analysis required multiple visits, but provided little additional information in detecting converters. (Invest Ophthalmol Vis Sci. 2011;52:4300-4306) DOI:10.1167/iovs.10-6381