Pangeni Gobinda, Lämmer Robert, Tornow Ralf P, Horn Folkert K, Kremers Jan
Department of Ophthalmology, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany.
Doc Ophthalmol. 2012 Jun;124(3):237-48. doi: 10.1007/s10633-012-9323-4. Epub 2012 Mar 29.
The aim of this study is to measure the on- and off-responses and their response asymmetries elicited by sawtooth stimuli in normal subjects and glaucoma patients. Furthermore, the correlation between the ERGs and other functional and structural parameters are investigated. Full-field stimuli were produced using a Ganzfeld bowl with Light Emitting Diodes (LEDs) as light sources. On- and off-response ERGs were recorded from 17 healthy subjects, 12 pre-perimetric and 15 perimetric glaucoma patients using 4-Hz luminance rapid-on and rapid-off sawtooth stimuli (white light; mean luminance 55 cd/m(2)) at 100% contrast. The on- and off-responses were added to study response asymmetries. In addition, flash ERGs were elicited by red stimuli (200 cd/m(2)) on a blue background (10 cd/m(2)). The mean deviations (MD) of the visual field defects were obtained by standard automated perimetry. The retinal nerve fibre layer thickness (RNFLT) was measured with Spectral Domain Optical Coherence Tomography (SOCT). We studied the correlation between ERG response amplitudes, visual field mean deviation (MDs) and RNFLT values. The on-responses showed an initial negative (N-on) followed by a positive (P-on), a late positive (LP-on) and a late negative responses (LN-on). The off-responses showed an initial positive (P-off) a late positive (LP-off) and a late negative response (LN-off). The addition of on- and off-responses revealed an initial positive (P-add) and a late negative response (LN-add). The on-response components (N-on, P-on and LN-on) in the glaucoma patients were relatively similar to those of the control subjects. However, the LP-on was significantly elevated (p = 0.03) in perimetric patients. The LP-off was significantly elevated (p < 0.001), and the amplitude of LN-off was significantly reduced in perimetric patients (p = 0.02). The LN-add amplitude was significantly reduced (p < 0.001) and delayed (p = 0.03) in perimetric patients. The amplitudes of the LN-off and LN-add ERG components were significantly correlated with the PhNR in the flash ERG (LN-off: p = 0.01; LN-add: p < 0.001) and with RNFLT (LN-off: p = 0.006; LN-add: p = 0.001). On- and off-response ERGs and their response asymmetries, elicited by sawtooth stimuli, are altered in the glaucoma patients. The late components are affected. Changes in the late negative components are correlated with structural and other functional changes.
本研究的目的是测量正常受试者和青光眼患者中由锯齿波刺激诱发的开反应和关反应及其反应不对称性。此外，还研究了视网膜电图（ERG）与其他功能和结构参数之间的相关性。使用以发光二极管（LED）作为光源的全视野刺激器产生全视野刺激。使用4赫兹亮度快速开和快速关的锯齿波刺激（白光；平均亮度55坎德拉每平方米），对比度为100%，记录了17名健康受试者、12名视野检查前和15名视野检查青光眼患者的开反应和关反应ERG。将开反应和关反应相加来研究反应不对称性。此外，在蓝色背景（10坎德拉每平方米）上用红色刺激（200坎德拉每平方米）诱发闪光ERG。通过标准自动视野检查获得视野缺损的平均偏差（MD）。用光谱域光学相干断层扫描（SOCT）测量视网膜神经纤维层厚度（RNFLT）。我们研究了ERG反应幅度、视野平均偏差（MDs）和RNFLT值之间的相关性。开反应表现出初始负向波（N-on），随后是正向波（P-on）、晚期正向波（LP-on）和晚期负向波（LN-on）。关反应表现出初始正向波（P-off）、晚期正向波（LP-off）和晚期负向波（LN-off）。开反应和关反应相加后显示出初始正向波（P-add）和晚期负向波（LN-add）。青光眼患者的开反应成分（N-on、P-on和LN-on）与对照组受试者相对相似。然而，视野检查患者的LP-on显著升高（p = 0.03）。视野检查患者的LP-off显著升高（p < 0.001），LN-off的幅度显著降低（p = 0.02）。视野检查患者的LN-add幅度显著降低（p < 0.001）且延迟（p = 0.03）。LN-off和LN-add ERG成分的幅度与闪光ERG中的视网膜电图负向反应（PhNR）显著相关（LN-off：p = 0.01；LN-add：p < 0.001），并与RNFLT相关（LN-off：p = 0.006；LN-add：p = 0.001）。锯齿波刺激诱发的开反应和关反应ERG及其反应不对称性在青光眼患者中发生改变。晚期成分受到影响。晚期负向成分的变化与结构和其他功能变化相关。
