Amanullah Sarah, Okudolo Joseph, Rahmatnejad Kamran, Lin Shuai-Chun, Wizov Sheryl S, Manzi Muhire Remy S, Hark Lisa A, Zheng Cindy X, Zhan Tingting, Spaeth George L
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Department of Research and Glaucoma Research Center, Wills Eye Hospital, 840 Walnut Street, Suite 1140, Philadelphia, PA, 19107, USA.
Graefes Arch Clin Exp Ophthalmol. 2017 Dec;255(12):2415-2422. doi: 10.1007/s00417-017-3789-4. Epub 2017 Sep 5.
To evaluate the correlation between contrast sensitivity (CS) and retinal nerve fiber layer (RNFL) in different areas of vision.
This report is a sub-analysis of a prospective, observational cohort study investigating changes in performance-based assessment, vision-related quality of life, and clinical measures in patients with moderate to advanced glaucoma. The study included 161 participants with at least a 2-year history of glaucoma who underwent annual testing for 4 years. Contrast sensitivity was measured using the Spaeth/Richman contrast sensitivity (SPARCS) test, while RNFL thickness (RNFLT) was measured using Cirrus optical coherence tomography (OCT). Statistical analyses were performed to determine correlations between CS and RNFLT; the correlations were calculated for each annual visit, totaling four correlation coefficients for each patient over the course of 4 years.
The SPARCS score in the left upper area of vision correlated the most strongly with the RNFLT of the inferior quadrant for both eyes at each annual visit, specifically in the seven o'clock sector for the left eye and the six o'clock sector for the right eye (p < 0.05). There were no discernible trends for the correlations between the other areas of CS and RNFL quadrants or clock hours over the 4 years of the study. Linear regression between the SPARCS total score and average RNFLT showed a significant direct correlation at each visit (p < 0.01).
Contrast sensitivity in the left upper area of vision for both eyes correlated most strongly with the thickness of the inferior quadrant of the RNFL. These fibers project to the temporal portion of the right occipital lobe, implying a potential center for contrast perception in this area. The longitudinal nature of the study suggests that CS may be a predictive tool for changes in RNFL in patients with glaucoma. Despite this finding, retinal damage and its relationship to CS was diffuse. In addition, SPARCS was shown to predict RNFLT. Further research is warranted to understand how CS can be used as a tool in the clinical setting.
评估不同视野区域的对比敏感度（CS）与视网膜神经纤维层（RNFL）之间的相关性。
本报告是一项前瞻性观察队列研究的子分析，该研究调查了中度至重度青光眼患者基于表现的评估、视力相关生活质量和临床指标的变化。该研究纳入了161名至少有2年青光眼病史的参与者，他们接受了为期4年的年度检测。使用Spaeth/Richman对比敏感度（SPARCS）测试测量对比敏感度，同时使用Cirrus光学相干断层扫描（OCT）测量RNFL厚度（RNFLT）。进行统计分析以确定CS与RNFLT之间的相关性；对每次年度就诊进行相关性计算，每位患者在4年期间共获得四个相关系数。
在每次年度就诊时，双眼视野左上方区域的SPARCS评分与下象限的RNFLT相关性最强，具体而言，左眼为7点方位，右眼为6点方位（p < 0.05）。在研究的4年中，CS的其他区域与RNFL象限或钟点之间的相关性没有明显趋势。SPARCS总分与平均RNFLT之间的线性回归在每次就诊时均显示出显著的正相关（p < 0.01）。
双眼视野左上方区域的对比敏感度与RNFL下象限的厚度相关性最强。这些纤维投射到右枕叶的颞部，这意味着该区域可能是对比感知的潜在中心。该研究的纵向性质表明，CS可能是青光眼患者RNFL变化的预测工具。尽管有这一发现，但视网膜损伤及其与CS的关系是弥散的。此外，SPARCS被证明可预测RNFLT。有必要进一步研究以了解如何在临床环境中使用CS作为一种工具。
