Pfeiffer N, Birkner-Binder D, Bach M
Universitäts-Augenklinik Mainz, Bundesrepublik Deutschland.
Fortschr Ophthalmol. 1991;88(6):815-8.
We have previously shown that check-size-specific changes of the Pattern-Electroretinogram (PERG) can be used to detect early glaucoma. This time we conducted a study to determine whether different check sizes, contrasts and eccentricities can improve the diagnostic yield. We examined 15 normal eyes (15 subjects), 32 eyes (24 patients) in stage I or II glaucoma and 36 eyes (25 patients) with ocular hypertension (OHT). Visual acuity was always better than 0.8. The stimuli were checkerboards, phase-reversing at 16 rev/s. The check sizes were 0.8 degrees or 15 degrees with contrast at 60% or 98%. The stimulation area was either "full-field" (27 degrees x 30 degrees), "central" (less than or equal to 7 degrees) or "paracentral" (greater than 7 degrees). In the glaucoma group, all PERG amplitudes were significantly reduced compared to normals: maximally for stimuli of 0.8 degrees, 98% contrast, full-field to 51% +/- 18%, and least for stimuli of 15 degrees, 98% contrast, central (to 70% +/- 20%). Under paracentral stimulation, the amplitude was reduced to 55% and in the central condition to 64%. The single-most-sensitive stimulus to separate normal and glaucoma patients was 0.8 degrees, 60% contrast and full-field, as the variance was low for this condition. Only 4 patients (8.5%) were incorrectly classified using these parameters; when 8 different stimuli were entered into the discriminant analysis, the rate was marginally reduced to 3 patients (6.4%). Seventy-five percent of the OHT eyes were classified as pathological. These results confirm previous findings that in early glaucoma, PERG amplitudes are more reduced using check sizes of 0.8 degrees compared to 15 degrees.(ABSTRACT TRUNCATED AT 250 WORDS)
我们之前已经表明,模式视网膜电图(PERG)特定方格大小的变化可用于检测早期青光眼。此次我们开展了一项研究,以确定不同的方格大小、对比度和离心度是否能提高诊断效率。我们检查了15只正常眼(15名受试者)、32只处于青光眼I期或II期的眼睛(24名患者)以及36只患有高眼压症(OHT)的眼睛(25名患者)。视力始终优于0.8。刺激物为棋盘格,以16转/秒的速度进行相位反转。方格大小为0.8度或15度,对比度为60%或98%。刺激区域要么是“全视野”(27度×30度)、“中央”(小于或等于7度),要么是“旁中央”(大于7度)。在青光眼组中,与正常组相比,所有PERG振幅均显著降低:对于0.8度、98%对比度、全视野刺激,最大降幅为51%±18%;对于15度、98%对比度、中央刺激(至7度),降幅最小(至70%±20%)。在旁中央刺激下,振幅降至55%,在中央条件下降至64%。区分正常人和青光眼患者的最敏感单一刺激是0.8度、60%对比度和全视野,因为这种情况下方差较低。使用这些参数时,只有4名患者(8.5%)被错误分类;当将8种不同刺激纳入判别分析时,该比率略微降至3名患者(6.4%)。75%的高眼压症眼睛被归类为病理性。这些结果证实了之前的发现,即在早期青光眼中,与15度方格大小相比,使用0.8度方格大小时PERG振幅降低得更多。(摘要截短于250字)