Najjar Raymond P, Sharma Sourabh, Drouet Morgane, Leruez Stephanie, Baskaran Mani, Nongpiur Monisha E, Aung Tin, Fielding Joanne, White Owen, Girard Michael J, Lamirel Cédric, Milea Dan
Singapore Eye Research Institute, Singapore 2The Ophthalmology and Visual Sciences Academic Clinical Program, Duke-National University of Singapore Medical School, Singapore.
Singapore Eye Research Institute, Singapore 3Singapore National Eye Centre, Singapore.
Invest Ophthalmol Vis Sci. 2017 Apr 1;58(4):2430-2437. doi: 10.1167/iovs.16-21002.
Primary open-angle glaucoma (POAG) can be associated with abnormal ocular motor behavior, possibly as a compensatory strategy following visual field loss. The aim of this study was to explore the characteristics of saccadic eye movements in patients with early-stage POAG without any detectable glaucomatous visual field loss (i.e., preperimetric POAG).
Binocular eye movements were explored in 16 patients with bilateral preperimetric POAG and 16 age-matched healthy controls in a cross-sectional, observational study. Visually guided horizontal prosaccades (5°, 10°, 15°, and 20° amplitude) and antisaccades (12° amplitude) were measured using infrared oculography. The latency, average and peak velocities, amplitude and gain of prosaccades as well as the percentage of errors in the antisaccades task were compared between groups.
POAG patients exhibited a reduced average velocity of saccades compared to controls across all amplitudes of peripheral visual target presentation (P = 0.03). Saccades performed by POAG patients were hypometric, and with reduced amplitude (P = 0.007) and gain (P = 0.01) compared to controls. On average, POAG patients displayed more antisaccade errors (40.6%), as compared to controls (23.4%; P = 0.04).
Here, we show that patients with POAG without detectable glaucomatous visual field loss exhibit altered saccadic eye movements. These abnormalities may indicate disordered cortical and subcortical saccadic regulation, either on the basis of subthreshold visual impairment, or as a result of wider disease-associated neurodegeneration. Additional studies, controlling for glaucoma medications, are required to delineate the neural basis of eye movement abnormalities associated with POAG.
原发性开角型青光眼（POAG）可能与异常的眼球运动行为有关，这可能是视野丧失后的一种代偿策略。本研究的目的是探讨早期POAG患者（即视野检查前POAG）在无任何可检测到的青光眼性视野丧失情况下的扫视运动特征。
在一项横断面观察性研究中，对16例双侧视野检查前POAG患者和16例年龄匹配的健康对照者进行双眼运动研究。使用红外眼动图测量视觉引导的水平前扫视（幅度为5°、10°、15°和20°）和反扫视（幅度为12°）。比较两组之间前扫视的潜伏期、平均速度和峰值速度、幅度和增益以及反扫视任务中的错误百分比。
在所有外周视觉目标呈现幅度下，POAG患者与对照组相比，扫视平均速度降低（P = 0.03）。与对照组相比，POAG患者的扫视幅度减小，幅度（P = 0.007）和增益（P = 0.01）降低。平均而言，POAG患者的反扫视错误比对照组更多（40.6%对23.4%；P = 0.04）。
在此，我们表明无可检测到的青光眼性视野丧失的POAG患者表现出扫视运动改变。这些异常可能表明皮质和皮质下扫视调节紊乱，其基础可能是阈下视觉损伤，或者是更广泛的疾病相关神经变性的结果。需要进一步研究，控制青光眼药物，以阐明与POAG相关的眼球运动异常的神经基础。
