Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Graefes Arch Clin Exp Ophthalmol. 2012 Feb;250(2):261-70. doi: 10.1007/s00417-011-1790-x. Epub 2011 Sep 1.
To investigate the association of the luminance-modulation global flash multifocal electroretinogram (mfERG) and other clinical assessments of vision in subsets of subjects at high risk of developing glaucomatous damage.
Eighteen subjects (28 eyes) with asymmetric glaucoma and ocular hypertension were measured in this longitudinal study of visual field, OCT, and multifocal electroretinogram (mfERG). Five ophthalmic examinations were scheduled, once every 12 months over a 4-year period. The mfERG was assessed using a luminance-modulated global flash stimulation paradigm. The adaptive index which we have reported previously was calculated.
There was a significant thinning of the peripapillary retinal nerve fiber layer over the course of the study for eyes with ocular hypertension, or for fellow eyes with asymmetric glaucoma which initially had an abnormal adaptive index; such eyes showed a thinning rate of -3.59 and -3.69 μm/year, respectively. However, no significant thinning was found for eyes which initially had a normal adaptive index. Two subjects were shown to have glaucomatous damage, confirmed by abnormal thinning of the retinal nerve fiber layer and visual field loss respectively at the last visit. However, these patients had shown an abnormal adaptive index in the mfERG measurement at the first visit.
The adaptive index calculated from the measurement of luminance-modulated global flash mfERG is useful for predicting progression of signs related to glaucoma, especially in high-risk groups. The abnormal adaptive index reflects the change in fast-adaptive mechanisms in the retina and indicates the risk of developing glaucoma.
探讨在青光眼高危人群亚组中，亮度调制全局闪烁多焦视网膜电图（mfERG）与其他视力临床评估的相关性。
本研究对 18 名（28 只眼）具有不对称青光眼和高眼压的受试者进行了前瞻性研究，对其视野、OCT 和多焦视网膜电图（mfERG）进行了测量。该研究共进行了 5 次眼科检查，每 12 个月进行一次，为期 4 年。使用亮度调制全局闪烁刺激范式评估 mfERG。我们之前报道过计算自适应指数。
在研究过程中，对于有高眼压的眼或最初具有异常自适应指数的不对称青光眼的对侧眼，视盘周围视网膜神经纤维层的厚度显著变薄；这些眼的变薄率分别为-3.59μm/年和-3.69μm/年。然而，对于最初具有正常自适应指数的眼，未发现明显的变薄。有 2 名受试者被诊断为青光眼损害，分别在最后一次就诊时发现视网膜神经纤维层变薄和视野丧失异常。然而，这些患者在 mfERG 测量的第一次就诊时就表现出异常的自适应指数。
从亮度调制全局闪烁 mfERG 测量中计算出的自适应指数可用于预测与青光眼相关的进展迹象，尤其是在高危人群中。异常的自适应指数反映了视网膜快速适应机制的变化，提示了发展为青光眼的风险。
