Functional Loss of the Inner Retina in Childhood Optic Gliomas Detected by Photopic Negative Response
Functional Loss of the Inner Retina in Childhood Optic Gliomas Detected by Photopic Negative Response
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DOI：
10.1167/iovs.14-16235
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发表时间：
2015-04-01
影响因子：
4.4
通讯作者：
Falsini, Benedetto
中科院分区：
文献类型：
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作者：
Abed, Edoardo;Piccardi, Marco;Falsini, Benedetto
目的。目的：探讨儿童视神经胶质瘤(OPG)患者视网膜内视网膜活动的Ganzfeld ERG明视阴性反应(PhNR)是否发生改变。方法：17例根据神经眼科和脑/眼眶磁共振成像(MRI)标准确诊的儿童OPG患者。检查方法包括视力(VA)、眼底检查、光谱域光学相干断层扫描(SD-OCT)测量视网膜神经纤维层(RNFL)和明视视网膜电图。15名正常儿童作为对照组。17例OPG患者中有10例在首次检查后1~3个月复查。在光适应10分钟后，对稳定的光适应背景上呈现的甘兹菲尔德闪光做出反应，记录照片ERG。结果：与正常组相比，OPG组PnR波幅明显降低(P<0.0001)。两组PhNR波峰时间、b波波幅和波峰时间相似。在受累于前交叉视路或后交叉视路的患者中，可发现PhNR的丢失。直线回归分析显示，神经纤维层厚度与PhNR波幅呈显著正相关(r(2)=0.34，P=0.008)。PhNR波幅和峰值时间的平均重测百分比差异分别为12%和6%。结论闪光ERG PhNR可以检测儿童OPG的视网膜内功能的丧失，支持该技术的使用，作为标准的心理物理和电生理检查的辅助，监测OPG的视觉功能。
PURPOSE. To determine whether the Ganzfeld ERG photopic negative response (PhNR), an assay of inner retinal activity, is altered in childhood optic glioma (OPG).METHODS. Seventeen pediatric patients with a diagnosis of OPG, established on neuro-ophthalmologic and brain/orbit magnetic resonance imaging (MRI) criteria, were enrolled. The examination protocol included determination of visual acuity (VA), fundus examination, retinal nerve fiber layer (RNFL) measurement with spectral-domain optical coherence tomography (SD-OCT) and photopic ERG. Fifteen normal children served as control group. Ten of the 17 OPG patients were retested 1 to 3 months after the first examination. Photopic ERGs were recorded after 10 minutes of light adaptation in response to a Ganzfeld flash presented on a steady light-adapting background. Amplitude and peak-time of b-wave and PhNR were measured.RESULTS. Compared with normal values, PhNR amplitude was significantly reduced (P < 0.0001) in the OPG group. Peak-time of PhNR as well as b-wave amplitude and peak-time were similar in both patients and controls. Losses of PhNR were found in patients with involvement of either anterior or retro-chiasmatic optic pathways. Linear regression analysis showed significant positive correlation between RNFL thickness and PhNR amplitude (r(2) = 0.34, P = 0.008). Mean percentage test-retest difference for PhNR amplitude and peak-time was 12% and 6%, respectively.CONCLUSIONS. These findings indicate that flash ERG PhNR can detect a loss of inner retinal function in childhood OPGs supporting the use of this technique, as an adjunct to standard psychophysical and electrophysiological tests, to monitor visual function in OPG.