Devers Eye Institute, Discoveries in Sight Research Laboratories, Legacy Research Institute, Legacy Health, Portland, Oregon, USA.
Invest Ophthalmol Vis Sci. 2012 Jun 22;53(7):3939-50. doi: 10.1167/iovs.12-9979.
To compare peripapillary retinal nerve fiber layer thickness (RNFLT), RNFL retardance, and retinal function at the onset of optic nerve head (ONH) surface topography change in experimental glaucoma (EG).
Thirty-three rhesus macaques had three or more weekly baseline measurements in both eyes of ONH surface topography, peripapillary RNFLT, RNFL retardance, and multifocal electroretinography (mfERG). Laser photocoagulation was then applied to the trabecular meshwork of one eye to induce chronic elevation of IOP and weekly recordings continued alternating between ONH surface topography and RNFLT during one week and RNFL retardance and mfERG the next week. Data were pooled for the group at the onset of ONH surface topography change in each EG eye, which was defined as the first date when either the mean position of the disc (MPD) fell below the 95% confidence limit of each eye's individual baseline range and/or when the topographic change analysis (TCA) map was subjectively judged as having demonstrated change, whichever came first. Analysis of variance with post hoc tests corrected for multiple comparisons were used to assess parameter changes.
At onset of ONH surface topography change, there was no significant difference for RNFLT versus baseline or fellow control eyes. RNFL retardance and mfERG were significantly reduced in the recordings just prior (median of 9 days) to ONH onset (P < 0.01) and had progressed significantly (P < 0.001) an average of 17 days later (median of 7 days after ONH onset). RNFLT did not exhibit significant thinning until 15 days after onset of ONH surface topography change (P < 0.001).
These results support the hypothesis that during the course of glaucomatous neurodegeneration, axonal cytoskeletal and retinal ganglion cell functional abnormalities exist before thinning of peripapillary RNFL axon bundles begins.
比较实验性青光眼（EG）中视盘表面形态变化起始时的视盘周围视网膜神经纤维层厚度（RNFLT）、RNFL 延迟和视网膜功能。
33 只恒河猴双眼均有 3 次或以上的视盘表面形态、视盘周围 RNFLT、RNFL 延迟和多焦视网膜电图（mfERG）的每周基线测量。然后对一只眼的小梁网进行激光光凝，以诱导慢性眼压升高，并在一周内交替进行视盘表面形态和 RNFLT 的每周记录，下一周进行 RNFL 延迟和 mfERG 的每周记录。当 EG 眼中任意一眼视盘表面形态变化的起始时间定义为：（1）视盘平均位置（MPD）首次降至各眼个体基线范围的 95%置信限以下，或（2）地形图分析（TCA）图首次主观判断出现变化，以先出现的为准。采用方差分析和多重比较校正的事后检验来评估参数变化。
在视盘表面形态变化起始时，与基线或对侧对照眼相比，RNFLT 没有显著差异。在视盘起始前（中位数为 9 天）的记录中，RNFL 延迟和 mfERG 显著降低（P < 0.01），并且在 17 天后（中位数为视盘起始后 7 天）显著进展（P < 0.001）。直到视盘表面形态变化开始后 15 天，RNFLT 才出现显著变薄（P < 0.001）。
这些结果支持假说，即在青光眼性神经退行性变过程中，在视盘周围 RNFL 轴突束变薄之前，就存在轴突细胞骨架和视网膜神经节细胞功能异常。
