青光眼与中枢神经系统。高眼压性青光眼和正常眼压性青光眼的功能磁共振成像结果比较。

Glaucoma and CNS. Comparison of fMRI results in high tension and normal tension glaucoma.

作者信息

Lestak Jan, Tintera Jaroslav, Svata Zuzana, Ettler Lukas, Rozsival Pavel

机构信息

Eye department of the Clinic JL, V Hurkach 1296/10, Prague, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014;158(1):144-53. doi: 10.5507/bp.2013.038. Epub 2013 Jun 4.

DOI:10.5507/bp.2013.038

PMID:23733146

Abstract

AIM

The objective of our work was to determine whether there is a difference in fMRI activation between patients with high tension glaucoma (HTG) and those with normal tension glaucoma (NTG).

METHOD

The sample consisted of eight patients with different stages of high tension glaucoma (3 females aged 41-65 and 5 males aged 40-73 years) and eight patients, also with different stages of normal tension glaucoma (6 females aged 53-70 and 2 males aged 40-52 years). The control group consisted of eight healthy subjects (3 females aged 23-46 and 5 males aged 23-65 years). All underwent complete ophthalmological examination, including visual field, colour vision, and electrophysiological functions. The results were compared with fMRI images after stimulation with black/white (BW) and blue/yellow (BY) checkerboard and then statistically processed.

RESULTS

The authors analyzed the results of published studies on high tension versus normal tension glaucoma in the images obtained by fMRI. They concluded on the basis of electrophysiological examinations that in high tension glaucoma, damage of the whole visual pathway occurs, starting from retinal ganglion cells up to the visual cortex. In normal tension glaucoma the response of ganglion cells is relatively normal. The pathology is found mainly in the visual pathway. For this reason, the authors carried out fMRI examinations in high tension glaucoma patients and patients with normal tension glaucoma. They found that advancing stages of high tension glaucoma cause progression of fMRI activity decrease. These relations were not observed in normal tension glaucoma cases. Similarly, in high tension glaucoma on fMRI examination to yellow/blue stimuli, the fMRI activity decrease was found to be greater than that to black/white stimulation. No similar effect was observed in normal tension glaucoma.

CONCLUSION

Normal tension glaucoma is, from the etiopathogenetical view, a different disease than high tension glaucoma.

摘要

目的

我们研究的目的是确定高眼压性青光眼（HTG）患者与正常眼压性青光眼（NTG）患者在功能磁共振成像（fMRI）激活方面是否存在差异。

方法

样本包括8例处于不同阶段的高眼压性青光眼患者（3例41 - 65岁女性和5例40 - 73岁男性）以及8例同样处于不同阶段的正常眼压性青光眼患者（6例53 - 70岁女性和2例40 - 52岁男性）。对照组由8名健康受试者组成（3例23 - 46岁女性和5例23 - 65岁男性）。所有人均接受了全面的眼科检查，包括视野、色觉和电生理功能检查。结果与经黑白（BW）和蓝黄（BY）棋盘格刺激后的fMRI图像进行比较，然后进行统计学处理。

结果

作者分析了fMRI获得的图像中关于高眼压性青光眼与正常眼压性青光眼已发表研究的结果。他们基于电生理检查得出结论，在高眼压性青光眼中，从视网膜神经节细胞到视觉皮层的整个视觉通路都会发生损伤。在正常眼压性青光眼中，神经节细胞的反应相对正常。病理主要发现于视觉通路。因此，作者对高眼压性青光眼患者和正常眼压性青光眼患者进行了fMRI检查。他们发现高眼压性青光眼的进展阶段会导致fMRI活动下降的进展。在正常眼压性青光眼病例中未观察到这些关系。同样，在高眼压性青光眼中进行fMRI检查时，发现对黄/蓝刺激的fMRI活动下降大于对黑/白刺激的下降。在正常眼压性青光眼中未观察到类似效果。