Erichev V P, Shamshinova A M, Egorova I V
Vestn Ross Akad Med Nauk. 2003(5):32-6.
Visual field losses and changes of the optic nerve disk are signs of optic neuropathy in glaucoma; psychophysical and electrophysiological tests can contribute to an early detection of glaucomatous optic neuropathy. Electrophysiological methods, like pattern electroretinogram (PERG) and visual induced cortical potentials can be useful in the diagnosis of glaucoma since they are compatible with the functions of retinal ganglion cells. A combination of psychophysical and electrophysiological examination methods contribute to an early diagnosis of glaucoma because they make it possible to study different aspects of visual functions. The results of psychophysical tests correlate to a greater extent than electrophysiological tests with defects in visual fields. Temporal, temporal-and-spatial contrast sensitivity and visual induced cortical potentials, whose changes are detected in the "preperimetric" stage of glaucoma, are the most sensitive parameters, while PERG changes later. Both the color contrast and light PERGs reduce in glaucoma. However, a significant correlation was detected only between the reduction of the color contrast PERG and visual field defects. A reduced sensitivity of dark and color channels of the retinal cone systems was also registered. Defects of color sensitivity are more pronounced and they precede the onset of light sensitivity changes. Defects of color and contrast sensitivity are an early sign of the progressing of optic neuropathy in glaucoma.
视野缺损和视神经盘改变是青光眼视神经病变的体征；心理物理学和电生理测试有助于早期发现青光眼性视神经病变。电生理方法，如图形视网膜电图（PERG）和视觉诱发电位，可用于青光眼的诊断，因为它们与视网膜神经节细胞的功能相符。心理物理学和电生理检查方法相结合有助于青光眼的早期诊断，因为它们能够研究视觉功能的不同方面。心理物理学测试结果与视野缺损的相关性比电生理测试更大。在青光眼的“视野前”阶段检测到变化的时间、时间和空间对比敏感度以及视觉诱发电位是最敏感的参数，而PERG变化较晚。青光眼患者的颜色对比和光PERG均降低。然而，仅在颜色对比PERG降低与视野缺损之间检测到显著相关性。视网膜锥系统的暗通道和颜色通道的敏感度也降低。颜色敏感度缺陷更明显，且在光敏感度变化之前出现。颜色和对比敏感度缺陷是青光眼视神经病变进展的早期迹象。
