Afonso Clara L, Raza Ali S, Kreuz André C, Hokazono Kenzo, Cunha Leonardo P, Oyamada Maria K, Monteiro Mário L R
Division of Ophthalmology and Laboratory of Investigation in Ophthalmology (LIM 33) University of São Paulo Medical School, São Paulo, Brazil.
Department of Psychology, Columbia University, New York, New York, United States 3Department of Neurobiology and Behavior, Columbia University, New York, New York, United States.
Invest Ophthalmol Vis Sci. 2015 Jun;56(6):3656-65. doi: 10.1167/iovs.15-16768.
We evaluated the ability of transient pattern electroretinogram (PERG) parameters to differentiate between eyes with visual field (VF) loss and resolved papilledema from pseudotumor cerebri syndrome (PTC) and controls, to compare PERG and optical coherence tomography (OCT) with regard to discrimination ability, and to assess the correlation between PERG, frequency domain OCT (FD-OCT), and VF measurements.
The VFs and full-field stimulation PERGs based on 48 and 14-min checks were obtained from patients with PTC (n = 24, 38 eyes) and controls (n = 26, 34 eyes). In addition, FD-OCT peripapillary retinal nerve fiber layer (RNFL) and segmented macular layer measurements were obtained and correlation coefficients were determined.
Compared to controls, PERG N95 and P50+N95 amplitude measurements with 48-minute checks were significantly reduced in eyes with resolved papilledema from PTC. Both PERG N95 amplitude and OCT parameters were able to discriminate papilledema eyes from controls with a similar performance. Significant correlations, ranging from 0.25 (P < 0.05) to 0.43 (P < 0.01) were found between PERG amplitude values and OCT-measured macular ganglion cell layer thickness, RNFL thickness, and total retinal thickness. The PERG amplitude also was significantly associated with VF sensitivity loss with correlation coefficients ranging from 0.24 (P < 0.05) and 0.35 (P < 0.01).
The PERG measurements were able to detect neural loss in PTC eyes with resolved papilledema and were reasonably well correlated with OCT measurements and VF parameters. Thus, PERG may be a useful tool in the monitoring of retinal neural loss in eyes with active papilledema from PTC.
我们评估了瞬态图形视网膜电图（PERG）参数区分视野（VF）丧失且视乳头水肿已消退的眼睛与假瘤性脑脊髓综合征（PTC）及对照组的能力，比较了PERG和光学相干断层扫描（OCT）的辨别能力，并评估了PERG、频域OCT（FD - OCT）和VF测量之间的相关性。
从PTC患者（n = 24，38只眼）和对照组（n = 26，34只眼）获取基于48分钟和14分钟检查的VF以及全视野刺激PERG。此外，还进行了FD - OCT视乳头周围视网膜神经纤维层（RNFL）和黄斑分层测量，并确定了相关系数。
与对照组相比，PTC中视乳头水肿已消退的眼睛在48分钟检查时，PERG的N95以及P50 + N95振幅测量值显著降低。PERG的N95振幅和OCT参数在区分视乳头水肿眼睛与对照组方面表现相似。在PERG振幅值与OCT测量的黄斑神经节细胞层厚度、RNFL厚度和总视网膜厚度之间发现了显著相关性，范围从0.25（P < 0.05）到0.43（P < 0.01）。PERG振幅也与VF敏感度丧失显著相关，相关系数范围从0.24（P < 0.05）到0.35（P < 0.01）。
PERG测量能够检测PTC中视乳头水肿已消退的眼睛中的神经损伤，并且与OCT测量和VF参数有较好的相关性。因此，PERG可能是监测PTC活动性视乳头水肿眼睛视网膜神经损伤的有用工具。
