Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Am J Ophthalmol. 2011 Mar;151(3):494-506.e1. doi: 10.1016/j.ajo.2010.09.018. Epub 2011 Jan 13.
To investigate in open-angle glaucoma the focal macular photopic negative response and spectral-domain optical coherence tomography measurements of retinal thicknesses in the superior and inferior macula.
Comparative case series.
We studied 63 eyes of 63 patients with open-angle glaucoma and 41 normal eyes of 41 volunteers. Photopic negative responses were recorded using a spotlight (diameter of 15 degrees of circle), projected onto the whole or superior or inferior macula. Ganglion cell complex (nerve fiber + ganglion cell + inner plexiform layers) thickness was measured using spectral-domain optical coherence tomography.
Mean photopic negative response amplitude over the entire macula was significantly (P < .001) decreased compared with that of controls in eyes with early (n = 24; to 62.1%), moderate (n = 21; to 57.2%), and severe (n = 18; to 49.3%) open-angle glaucoma, but not significantly different among eyes with various stages of glaucoma. Mean ganglion cell complex thickness was significantly (P < .001) decreased compared with that of controls in eyes with early (86.0%), moderate (78.3%), and severe (71.2%) glaucoma, and thinning correlated positively with glaucoma severity (P < .001). Mean photopic negative response amplitude correlated significantly (P < .001) with ganglion cell complex thickness over the whole, superior, and inferior macular areas (r = 0.57 to 0.74). In 16 eyes without visual field defect in the inferior hemifield, mean photopic negative response amplitude was 56.5% of normal (P < .001), and mean ganglion cell complex thickness in the superior macula was 92.1% of normal (P = .004).
Focal macular photopic negative response amplitude correlates with ganglion cell complex thickness, but decreases more abruptly in early glaucoma compared with ganglion cell complex thickness.
研究开角型青光眼患者黄斑区光刺激负反应及频域光相干断层扫描测量视网膜上、下极厚度的情况。
对比病例系列。
我们研究了 63 例开角型青光眼患者的 63 只眼和 41 名志愿者的 41 只正常眼。用一个直径为 15 度的聚光灯将光斑投射到整个或上或下黄斑区来记录光刺激负反应。用频域光相干断层扫描测量神经节细胞复合体（神经纤维+节细胞+内丛状层）的厚度。
与对照组相比，早期（n=24；至 62.1%）、中度（n=21；至 57.2%）和重度（n=18；至 49.3%）开角型青光眼患者整个黄斑区的光刺激负反应平均振幅显著降低（P<.001），但各期青光眼患者之间差异无统计学意义。与对照组相比，早期（86.0%）、中度（78.3%）和重度（71.2%）青光眼患者的神经节细胞复合体厚度明显变薄（P<.001），变薄与青光眼严重程度呈正相关（P<.001）。整个、上、下黄斑区的光刺激负反应平均振幅与神经节细胞复合体厚度显著相关（r=0.57 至 0.74）（P<.001）。在 16 只下半球视野无缺损的眼中，光刺激负反应平均振幅为正常的 56.5%（P<.001），上极神经节细胞复合体厚度为正常的 92.1%（P=.004）。
黄斑区光刺激负反应振幅与神经节细胞复合体厚度相关，但与神经节细胞复合体厚度相比，在早期青光眼时下降更明显。
