Nakamura Makoto, Kato Kei, Kamata Seiko, Ishikawa Kumiko, Nagai Takayuki
Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan,
Doc Ophthalmol. 2014 Jun;128(3):179-89. doi: 10.1007/s10633-014-9431-4. Epub 2014 Mar 11.
We have previously reported that the degree of signal-to-noise ratio (SNR) distribution overlaps between a signal window and a noise window in multifocal VEP (mfVEP) responses, which is determined by the area under the receiver-operating characteristic curve termed SNR-AUC, can quantitatively detect glaucomatous visual functional damage. However, the effect of high myopia on this parameter is not yet known.
SNR-AUC, total deviation, and retinal sensitivity on the Humphrey visual field (HVF) test were compared among 34 eyes>-6 diopters (control) and 21 eyes≤-6 diopters (high myopia), both of which were ophthalmoscopically normal and had a best-corrected visual acuity of 20/20. The mfVEP and HVF parameters were obtained from stimulus areas that corresponded to both HVF 24-2 and 10-2 programs.
Both the HVF 24-2 total deviation and the SNR-AUC obtained from 60 sectors in high-myopia patients were significantly lower compared with controls (P=0.045 and P=0.003, respectively). The SNR-AUC obtained from the central 36 sectors that corresponded to the HVF 10-2 area in high-myopia patients was also significantly lower than that of the controls (P=0.01). Multiple regression analyses demonstrated that age and refractive error were significantly associated with retinal sensitivity on the HVF 24-2 and SNR-AUC for the whole field and central field, respectively.
High myopia reduces the SNR-AUC of mfVEP responses, even with refractive correction. A normative database should be separately established for high myopes to evaluate the mfVEP responses obtained from highly myopic glaucoma patients.
我们之前曾报道，多焦视觉诱发电位（mfVEP）反应中信号窗口与噪声窗口之间的信噪比（SNR）分布重叠程度，由称为SNR-AUC的接受者操作特征曲线下面积决定，可定量检测青光眼性视觉功能损害。然而，高度近视对该参数的影响尚不清楚。
比较了34只屈光度＞-6D（对照组）和21只屈光度≤-6D（高度近视组）眼的SNR-AUC、总偏差以及Humphrey视野（HVF）检查中的视网膜敏感度，所有这些眼睛眼底镜检查均正常且最佳矫正视力为20/20。mfVEP和HVF参数是从与HVF 24-2和10-2程序相对应的刺激区域获得的。
与对照组相比，高度近视患者的HVF 24-2总偏差以及从60个扇形区域获得的SNR-AUC均显著降低（分别为P = 0.045和P = 0.003）。高度近视患者中与HVF 10-2区域相对应的中央36个扇形区域获得的SNR-AUC也显著低于对照组（P = 0.01）。多元回归分析表明，年龄和屈光不正分别与HVF 24-2的视网膜敏感度以及全视野和中央视野的SNR-AUC显著相关。
即使进行了屈光矫正，高度近视仍会降低mfVEP反应的SNR-AUC。应单独为高度近视者建立一个规范数据库，以评估高度近视性青光眼患者的mfVEP反应。
