Kremláček Jan, Jirásková Naďa, Nekolová Jana, Šikl Radovan, Kuba Miroslav
Department of Pathological Physiology, Faculty of Medicine in Hradec Králové, Charles University, Šimkova 870, 500 38, Hradec Králové, Czech Republic.
Department of Ophthalmology, Faculty of Medicine in Hradec Králové, University Hospital and Charles University, Prague, Czech Republic.
Doc Ophthalmol. 2016 Dec;133(3):171-181. doi: 10.1007/s10633-016-9563-9. Epub 2016 Nov 10.
The implantation of an intraocular telescope increases life quality in patients with end-stage age-related macular degeneration (AMD). The present study monitored changes in electrophysiological markers of visual processing before and during seventeen months after a novel mirror telescope implantation in two patients (OV-male 90 years, MZ-female 70 years) with the final-stage form of AMD.
Visual evoked potentials were recorded to high-contrast pattern-reversal (PR-VEP for check size 40' and 10'), low-contrast motion-onset stimuli (in visual periphery M-VEP M20°, and in central part M-VEP C8°), and event-related potentials (ERPs) in the oddball visual paradigm.
MZ's more systematic responses showed attenuation and prolongation of the M-VEP M20° and the PR-VEP 40' immediately after the telescope implantation with a slow amplitude recovery with unchanged prolonged latency. The implantation completely eradicated the M-VEP C8° without any restoration. The PR-VEP 10' were not readable. Only a part of OV's PR-VEP 40' and M-VEP M20' were of a repeatable and expected morphology. These OV's VEPs were consistent with MZ's findings. The ERPs did not show any effect of implantation in both patients. Post-implantation visual acuity and reaction time overcame the pre-implantation levels.
The mirror telescope preserved peripheral vision in contrast to classic telescopes; however, the telescope concurrently reduced the luminance of the magnified retinal image, which was likely responsible for the prolongation of the VEP latencies.
植入人工眼内望远镜可提高晚期年龄相关性黄斑变性(AMD)患者的生活质量。本研究监测了两名晚期AMD患者(OV,男性,90岁;MZ,女性,70岁)在植入新型镜面望远镜之前及之后十七个月内视觉处理电生理标志物的变化。
记录视觉诱发电位,包括高对比度模式反转刺激(用于40'和10'检查大小的PR-VEP)、低对比度运动起始刺激(在视觉周边为M-VEP M20°,在中央部分为M-VEP C8°)以及奇偶数视觉范式中的事件相关电位(ERP)。
MZ的反应更具系统性,在望远镜植入后立即出现M-VEP M20°和PR-VEP 40'的衰减和延长,振幅恢复缓慢且潜伏期延长不变。植入完全消除了M-VEP C8°且未恢复。PR-VEP 10'无法读取。只有部分OV的PR-VEP 40'和M-VEP M20'具有可重复且预期的形态。这些OV的VEP与MZ的结果一致。两名患者的ERP均未显示植入的任何影响。植入后的视力和反应时间超过了植入前水平。
与传统望远镜相比,镜面望远镜保留了周边视力;然而,该望远镜同时降低了放大视网膜图像的亮度,这可能是导致VEP潜伏期延长的原因。