Department of Ophthalmology, University of Athens, Ekali, Greece.
BMC Ophthalmol. 2012 Aug 2;12:34. doi: 10.1186/1471-2415-12-34.
To evaluate objectively the anatomical and functional changes of optic nerve in eyes with primary open angle glaucoma (POAG) by the joint use of optical coherence tomography (OCT) and multifocal visual evoked potentials (mfVEP).
29 eyes with open angle glaucoma and visual field defects, as well as 20 eyes of 10 age-matched control normal subjects were tested. All participants underwent a complete ophthalmological examination. Moreover, Humphrey visual field test, OCT examination and recording of mfVEP were performed. Amplitude and implicit time of mfVEP, as well as RNFL thickness were measured. Differences in density components of mfVEP and in RNFL thickness among POAG eyes and control eyes were examined using Student's t-test.
In glaucomatous eyes the mean Retinal Response Density (RRD) was lower than normal in ring 1, 2 and 3 of mfVEP (p < 0.0001). Specifically the mean amplitude of mfVEP in POAG eyes was estimated at 34.2 ± 17.6 nV/deg2, 6.9 ± 4.8 nV/deg2 and 2.6 ± 1.6 nV/deg2 in rings 1, 2 and 3 respectively. In contrast the mean implicit time was similar to control eyes. In addition, the mean RNFL thickness in POAG eyes was estimated at 76.8 ± 26.6 μm in the superior area, 52.1 ± 16.3 μm in the temporal area, 75.9 ± 32.5 μm in the inferior area and 58.6 ± 19.4 μm in the nasal area. There was a statistically significant difference in RNFL thickness in all peripapillary areas (p < 0.0001) between POAG eyes and controls, with superior and inferior area to present the highest decrease.
Our study shows that, although Standard Automatic Perimetry is the gold standard to evaluate glaucomatous neuropathy, the joint use of mfVEP and OCT could be useful in better monitoring glaucoma progression.
通过光学相干断层扫描（OCT）和多焦视觉诱发电位（mfVEP）联合使用，客观评估原发性开角型青光眼（POAG）患者视神经的解剖和功能变化。
共纳入 29 只患有开角型青光眼和视野缺损的眼，以及 20 只年龄匹配的正常对照组眼。所有参与者均接受了全面的眼科检查。此外，还进行了 Humphrey 视野检查、OCT 检查和 mfVEP 记录。测量 mfVEP 的振幅和潜伏期以及 RNFL 厚度。使用 Student's t 检验比较 POAG 眼和对照组眼中 mfVEP 密度成分和 RNFL 厚度的差异。
在青光眼眼中，多焦视觉诱发电位环 1、2 和 3 的平均视网膜反应密度（RRD）低于正常（p < 0.0001）。具体来说，POAG 眼的 mfVEP 平均振幅分别估计为 34.2 ± 17.6 nV/deg2、6.9 ± 4.8 nV/deg2 和 2.6 ± 1.6 nV/deg2。相比之下，平均潜伏期与对照组相似。此外，POAG 眼的平均 RNFL 厚度在上方区域估计为 76.8 ± 26.6 μm，在颞侧区域为 52.1 ± 16.3 μm，在下方区域为 75.9 ± 32.5 μm，在鼻侧区域为 58.6 ± 19.4 μm。POAG 眼和对照组之间在所有视盘周围区域的 RNFL 厚度均存在统计学显著差异（p < 0.0001），其中上方和下方区域的下降最为明显。
我们的研究表明，尽管标准自动视野计是评估青光眼性神经病的金标准，但 mfVEP 和 OCT 的联合使用可能有助于更好地监测青光眼的进展。
