Structure-function relationship in ocular hypertension and glaucoma: interindividual and interocular analysis by OCT and pattern ERG
Structure-function relationship in ocular hypertension and glaucoma: interindividual and interocular analysis by OCT and pattern ERG
复制标题
DOI：
10.1007/s00417-008-0808-5
复制
发表时间：
2008-08-01
影响因子：
2.7
通讯作者：
Colotto, Alberto
中科院分区：
文献类型：
--
作者：
Falsini, Benedetto;Marangoni, Dario;Colotto, Alberto
背景图视网膜电图（PERG）和光学相干断层扫描（OCT）作为客观探针，分别研究视网膜神经节细胞的功能及其作为视网膜神经纤维层（RNFL）厚度的结构。在高眼压（OHT）和早期青光眼（EG）患者中，我们研究了PERG振幅和RNFL厚度的个体间（II）相关性，以及两种测量方法的眼间（IO）差异的相关性。方法双眼检查OHT 31例，EG 34例（平均偏差-1 ~ -6 dB），同龄对照16例。参与者有清晰的光学介质，没有或中度屈光不正，没有伴随的眼部或全身性疾病。PERGs是通过对相光栅（16.28次反转/秒）（1.6个周期/度空间频率）引发的。测量了傅里叶分离二次谐波PERG的幅值和相位。采用OCT层图方法定量RNFL厚度。考虑平均、优、劣RNFL厚度。结果与对照组相比，OHT和EG患者的平均PERG幅度均降低（p < 0.01）。与OHT和对照组相比，EG患者的RNFL平均厚度均降低（p < 0.01）。在OHT患者中，在II和IO分析中，PERG振幅与RNFL厚度没有显著相关性。在EG患者中，在II （p < 0.005）和IO （p < 0.001）分析中，PERG振幅与RNFL厚度呈正相关。相关性斜率预测，当RNFL在0 ~ -0.25 log单位之间时，PERG损失超过系统RNFL损失。结论II和IO分析均显示OHT缺乏结构-功能关系，表明在该疾病阶段，PERG损失似乎主要影响视网膜/视神经头功能。在EG中，它们反映了功能障碍和RNFL的丧失。
Background Pattern electroretinogram (PERG) and optical coherence tomography (OCT) represent objective probes to investigate respectively the function of retinal ganglion cells and their structure as retinal nerve fiber layer (RNFL) thickness. We examined interindividual (II) correlations of PERG amplitude and RNFL thickness, as well as correlations between interocular (IO) differences in both measures, in ocular hypertension (OHT) and early glaucoma (EG) patients.Methods Thirty-one OHT, 34 EG (mean deviation: -1 to -6 dB) and 16 age-matched controls were examined in both eyes. Participants had clear optical media, no or moderate refractive errors and no concomitant ocular or systemic diseases. PERGs were elicited by counterphased (16.28 reversals/second) gratings (1.6 cycles/degree spatial frequency). The Fourier isolated 2nd harmonic PERG amplitude and phase were measured. RNFL thickness was quantified by means of OCT Stratus according to a standard protocol. Average, superior and inferior RNFL thicknesses were considered.Results Mean PERG amplitude was decreased (p < 0.01) in both OHT and EG patients compared to controls. Mean RNFL thicknesses were reduced (p < 0.01) in EG patients compared to both OHT and controls. In OHT patients, PERG amplitude did not correlate significantly with RNFL thickness in both II and IO analysis. In EG patients, PERG amplitude was positively correlated with RNFL thickness in both II (p < 0.005) and IO (p < 0.001) analysis. The slope of the correlation predicted that PERG losses exceeded systematically RNFL losses when the latter were between 0 and -0.25 log units.Conclusions Both II and IO analyses revealed a lack of structure-function relationship in OHT, suggesting that, at this disease stage, PERG losses appear to affect primarily retinal/optic nerve head function. In EG they reflect both dysfunction and RNFL loss.