Princess Alexandra Eye Pavilion, Edinburgh, UK.
Br J Ophthalmol. 2011 Dec;95(12):1656-9. doi: 10.1136/bjophthalmol-2011-300677. Epub 2011 Sep 27.
BACKGROUND/AIMS: Since 2002 the discovery of a novel population of intrinsically photosensitive retinal ganglion cells, expressing the photopigment melanopsin, has attracted broad interest in human blue-light mediated non-visual effects including circadian regulation and cognitive function. Ageing is associated with insomnia and cognitive decline. It has been postulated that reduced blue-light transmission through the formation of cataract impairs melanopsin dependant non-visual brain responses mediated by intrinsically photosensitive retinal ganglion cells. We aimed to establish if any objective improvement in cognition could be demonstrated using a reaction time task (RTT) following cataract surgery and intraocular lens implantation.
Following strict inclusion and exclusion criteria, 15 patients (age range 59-87, mean 75.4 years) with bilateral cataract performed the RTT before and after surgery on one eye. The mean and the SD of two modalities of reaction time, namely complex reaction time and simple reaction time, were measured and analysed.
Responses became both quicker and more consistent following surgery, with statistically significant improvements in the complex reaction time (p=0.016) and the complex reaction time SD (p=0.055), which were not due to a learning effect or improved vision.
The results suggest that improved blue-light transmission following cataract surgery has a beneficial effect on cognitive function. We advocate the RTT as an objective platform for exploring these benefits in large sample randomised controlled trials.
背景/目的：自 2002 年发现新型内在感光视网膜神经节细胞以来，这种细胞表达感光色素黑视素，引起了人们对人类蓝光介导的非视觉效应的广泛兴趣，包括昼夜节律调节和认知功能。衰老与失眠和认知能力下降有关。据推测，白内障的形成导致蓝光传输减少，会损害内在感光视网膜神经节细胞介导的依赖黑视素的非视觉大脑反应。我们旨在确定白内障手术后和人工晶状体植入后，使用反应时间任务（RTT）是否可以证明任何认知功能的客观改善。
在严格的纳入和排除标准下，15 名（年龄范围 59-87 岁，平均 75.4 岁）双侧白内障患者在一只眼接受手术前后进行了 RTT。测量和分析了两种反应时间模式（复杂反应时间和简单反应时间）的平均值和标准差。
手术后反应速度变快且更一致，复杂反应时间（p=0.016）和复杂反应时间标准差（p=0.055）有统计学显著改善，这不是由于学习效应或视力改善所致。
结果表明，白内障手术后蓝光传输的改善对认知功能有有益的影响。我们提倡使用 RTT 作为在大型随机对照试验中探索这些益处的客观平台。
