Evaluation of residual retinal function by pupillary constrictions and phosphenes using transcorneal electrical stimulation in patients with retinal degeneration
Evaluation of residual retinal function by pupillary constrictions and phosphenes using transcorneal electrical stimulation in patients with retinal degeneration
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DOI：
10.1007/s00417-006-0260-3
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发表时间：
2006-10-01
影响因子：
2.7
通讯作者：
Fujikado, Takashi
中科院分区：
文献类型：
--
作者：
Morimoto, Takeshi;Fukui, Takehiro;Fujikado, Takashi
背景资料：通过经角膜电刺激（TES）诱发的瞳孔收缩和光幻视评价遗传性视网膜变性患者的视网膜内功能。研究方法：在大坂大学医院，20例患者（16例视网膜色素变性（RP）和4例锥-杆营养不良（CRD））的20只眼睛的视力等于或低于20/2000和8例健康受试者的8只眼睛被招募。用接触透镜刺激电极进行TES。电诱发瞳孔反应（EEPR）由瞳孔计记录，光幻视由主观反应记录。测量三个电流阈值：T1，初始光幻视阈值电流; T2，引发光幻视延伸到中央视野的阈值; P，瞳孔相对收缩N3%的阈值。结果：T1、T2、P均显著高于正常人（Mann-Whitney，P < 0.001）。T1和T2与视力无关，但取决于残余视野的面积和位置。有EEPR的RP眼的T1和T2显著低于无EEPR的RP眼。在TES期间，所有受试者和患者均无疼痛，除轻度角膜浅表点状角膜病变外，无并发症。结论：TES评估视网膜变性患者残余视网膜内功能的安全性和有效性表明，TES可作为选择视网膜假体候选者的最重要测试之一。
Background: To evaluate inner-retinal function by pupillary constrictions and phosphenes evoked by transcorneal electrical stimulation (TES) in patients with hereditary retinal degeneration. Methods: Consecutive 20 eyes of 20 patients (16 with retinitis pigmentosa (RP); and four with cone-rod dystrophy (CRD)) whose visual acuity was equal to or worse than 20/2000 at Osaka University Hospital and eight eyes of eight healthy subjects were enrolled. TES was performed on with a contact lens stimulating electrode. The electrically evoked pupillary response (EEPR) was recorded by a pupillometer, and the phosphenes by the subjective responses. Three electrical current thresholds were determined: T1, threshold current for initial phosphene; T2, threshold for eliciting a phosphene extending into the central field; and P, threshold for a relative pupillary constriction N3%.The EEPR and phosphene thresholds were compared with the visual acuity or the visual field. Results: All T1, T2 and P were significantly higher in patients than in normals (Mann-Whitney, P < 0.001). Both T1 and T2 were not correlated with visual acuity but depended on the area and location of the residual visual field. T1 and T2 in RP eyes with a EEPR was significantly lower than that in RP eyes without an EEPR. During TES, all subjects and patients had no pain, and no complications except for a slight corneal superficial punctuate keratopathy. Conclusions: The safety and the efficacy of TES to estimate the residual inner-retinal function in patients with retinal degeneration indicate that TES can be used as one of the most important test to select candidates for retinal prostheses.