Fondazione G.B. Bietti-Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.
Invest Ophthalmol Vis Sci. 2012 Oct 9;53(11):6973-80. doi: 10.1167/iovs.12-10256.
To evaluate macular function in patients with open-angle glaucoma (OAG) by means of multifocal electroretinogram (mfERG).
Twenty-four OAG patients (mean age 54.6 ± 9.1 years) and 14 age-similar controls were enrolled. OAG patients had intraocular pressure (IOP) less than 18 mm Hg with topical medical treatment, 24-2 visual field (Humphrey Field Analyzer [HFA]) with mean deviation (MD) between -2 and -12 dB, and corrected pattern standard deviation (CPSD) between +2 and +10 dB and no history or presence of cataract and/or macular disease. MfERGs in response to 61 M-stimuli presented to the central 20° of the visual field were assessed in OAG patients (24 eyes) and in controls (14 eyes). Ring (R) analysis was performed every five retinal eccentricities in areas between the fovea and midperiphery: 0° to 2.5° (R1), 2.5° to 5° (R2), 5° to 10° (R3), 10° to 15° (R4), and 15° to 20° (R5). MfERG response amplitude density of the N1-P1 components (N1-P1 RAD, nV/deg(2)) and P1 implicit time (P1 IT, ms) of the first-order binary kernel were measured for each ring.
OAG patients showed a significant (P < 0.01) decrease in N1-P1 RADs and an increase in P1 IT in both R1 and R2 with respect to controls. The reduction in N1-P1 RADs was significantly (P < 0.01) correlated with HFA MD and CPSD. No other significant differences between OAG and controls were found.
OAG patients show macular dysfunction detectable by the mfERG technique. Since the mfERG N1-P1 component is thought to be generated by preganglionic elements (photoreceptors and OFF bipolar cells), our data support the functional impairment of the neural generators of the macular region in patients with glaucoma.
通过多焦视网膜电图(mfERG)评估开角型青光眼(OAG)患者的黄斑功能。
纳入 24 名 OAG 患者(平均年龄 54.6±9.1 岁)和 14 名年龄匹配的对照组。OAG 患者眼压(IOP)低于 18mmHg,接受局部药物治疗,24-2 视野(Humphrey 视野分析仪 [HFA])平均偏差(MD)在-2 至-12dB 之间,校正模式标准偏差(CPSD)在+2 至+10dB 之间,无白内障和/或黄斑疾病史或存在。对 24 只眼的 OAG 患者(24 只眼)和对照组(14 只眼)的中央 20°视野中的 61 个 M 刺激进行 mfERG 评估。在注视点到周边 20°的视网膜范围内,每隔 5 个视网膜偏心度进行环(R)分析:0°至 2.5°(R1)、2.5°至 5°(R2)、5°至 10°(R3)、10°至 15°(R4)和 15°至 20°(R5)。测量每个环的 N1-P1 成分的 mfERG 反应幅度密度(N1-P1 RAD,nV/deg2)和一阶二值核的 P1 隐时(P1 IT,ms)。
与对照组相比,OAG 患者在 R1 和 R2 中均显示 N1-P1 RAD 显著降低(P<0.01)和 P1 IT 显著延长(P<0.01)。N1-P1 RAD 的降低与 HFA MD 和 CPSD 显著相关(P<0.01)。OAG 患者与对照组之间无其他显著差异。
OAG 患者表现出黄斑功能障碍,可通过 mfERG 技术检测。由于 mfERG N1-P1 成分被认为是由节前成分(光感受器和 OFF 双极细胞)产生的,我们的数据支持青光眼患者黄斑区域神经发生器的功能障碍。