Vottonen Pasi, Kaarniranta Kai, Pääkkönen Ari, Tarkka Ina M
Department of Ophthalmology, Kuopio University Hospital, Kuopio, Finland.
Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Clin Ophthalmol. 2017 Jul 3;11:1245-1252. doi: 10.2147/OPTH.S132583. eCollection 2017.
People with age-related macular degeneration (AMD) have difficulties in familiar face recognition and facial expression discrimination. Our aim was to evaluate the visual processing of faces in AMD patients and whether this would be improved by anti-vascular endothelial growth factor therapy. This was a prospective interventional cohort study.
Twelve patients with monocular wet AMD and 6 control subjects were recruited. Face detection processes were studied using cortical event-related potentials (ERPs). Patients received 3 bevacizumab intravitreal injections to the single affected eye. At baseline and 4-6 weeks after the last injection, clinical presentation and ERPs of the face task were evaluated. Face pictures were shown as targets (16.7%) among standard pictures of pixelated faces in an oddball-type paradigm.
Face pictures elicited well-defined electrical components in occipital and parieto-occipital cortical areas at baseline and after treatment. The face-specific N170 component was evident in all subjects with longer peak latency in patients than in controls (170±13 vs 155±14, =0.032). Unexpectedly, an early component reflecting unintentional prediction of perceiving a face, that is, deviance-related negativity, was present in patients and controls. Visual acuity of the affected eye seemed improved in patients from logarithm of the minimum angle of resolution 0.71 (±0.33) to 0.52 (±0.39) by 119 (±23) days without accompanying significant change in face-specific ERPs.
Monocular wet AMD distinctly influenced face-specific brain electrophysiological components. However, the anti-vascular endothelial growth factor treatment did not improve the binocular face detection ability. The EudraCT number of this study is 2012-000765-20.
年龄相关性黄斑变性（AMD）患者在识别熟悉面孔和辨别面部表情方面存在困难。我们的目的是评估AMD患者对面部的视觉处理能力，以及抗血管内皮生长因子治疗是否能改善这种情况。这是一项前瞻性干预队列研究。
招募了12名单眼湿性AMD患者和6名对照受试者。使用皮层事件相关电位（ERP）研究面部检测过程。患者接受3次玻璃体内注射贝伐单抗至单眼患眼。在基线期和最后一次注射后4 - 6周，评估面部任务的临床表现和ERP。在奇偶数类型范式中，面部图片作为目标（16.7%）出现在像素化面部的标准图片中。
面部图片在基线期和治疗后在枕叶和枕顶叶皮质区域引发了明确的电成分。面部特异性N170成分在所有受试者中均明显，患者的峰值潜伏期比对照组更长（170±13 vs 155±14，P = 0.032）。出乎意料的是，患者和对照组中均存在一种反映对面部感知的无意预测的早期成分，即偏差相关负波。患眼的视力似乎在119（±23）天内从最小分辨角对数0.71（±0.33）提高到了0.52（±0.39），而面部特异性ERP没有伴随显著变化。
单眼湿性AMD明显影响面部特异性脑电生理成分。然而，抗血管内皮生长因子治疗并未改善双眼面部检测能力。本研究的欧盟临床试验注册号为2012 - 000765 - 20。
