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经角膜电刺激治疗原发性开角型青光眼的疗效:一项初步研究。

The Efficacy of Transcorneal Electrical Stimulation for the Treatment of Primary Open-angle Glaucoma: A Pilot Study.

作者信息

Ota Yuka, Ozeki Naoki, Yuki Kenya, Shiba Daisuke, Kimura Itaru, Tsunoda Kazushige, Shinoda Kei, Ohde Hisao, Tsubota Kazuo

机构信息

Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.

Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan.

出版信息

Keio J Med. 2018 Sep 25;67(3):45-53. doi: 10.2302/kjm.2017-0015-OA. Epub 2018 Feb 7.

Abstract

The aim of this study was to evaluate the effects of transcorneal electrical stimulation in subjects with primary open-angle glaucoma. Five eyes of four male subjects with primary open-angle glaucoma (average age: 52.25 ± 14.68 years) were enrolled. The subjects underwent transcorneal electrical stimulation every 3 months according to the following procedure. A Dawson-Trick-Litzkow electrode was placed on the cornea, and biphasic electric current pulses (10 ms, 20 Hz) were delivered using a stimulator (BPG-1,BAK Electronics) and a stimulus isolation unit (BSI-2). A current that evoked a phosphene that the subject perceived in the whole visual area was delivered continuously for 30 min. Humphrey visual field testing was performed after every third transcorneal electrical stimulation treatment. Changes in mean deviation (MD) values were evaluated with a linear regression model. Transcorneal electrical stimulation was performed 18.2 ± 9.4 times over a period of 49.8 ± 23.0 months. The average pretranscorneal electrical stimulation intraocular pressure, best corrected visual acuity, and MD values were 11.8 ± 1.79 mmHg, 0.14 ± 0.19 (logMAR) and -17.28 ± 6.24 dB, respectively. No significant differences were observed in intraocular pressure before and after transcorneal electrical stimulation. However, there was a significant positive linear relationship between changes in MD values and the number of transcorneal electrical stimulation treatments (R = 0.176, P = 0.005, Spearman correlation R =0.294, P = 0.008). Transcorneal electrical stimulation treatment may improve glaucomatous visual field defects in subjects with primary open-angle glaucoma. Large-scale studies are necessary to confirm these preliminary findings.

摘要

本研究的目的是评估经角膜电刺激对原发性开角型青光眼患者的影响。纳入了4名患有原发性开角型青光眼的男性受试者的5只眼睛(平均年龄:52.25±14.68岁)。受试者按照以下程序每3个月接受一次经角膜电刺激。将Dawson-Trick-Litzkow电极置于角膜上,使用刺激器(BPG-1,BAK电子公司)和刺激隔离单元(BSI-2)施加双相电流脉冲(10 ms,20 Hz)。以能诱发受试者在整个视野中感知到光幻视的电流持续施加30 min。每三次经角膜电刺激治疗后进行Humphrey视野检测。用线性回归模型评估平均偏差(MD)值的变化。在49.8±23.0个月的时间内进行了18.2±9.4次经角膜电刺激。经角膜电刺激前的平均眼压、最佳矫正视力和MD值分别为11.8±1.79 mmHg、0.14±0.19(logMAR)和-17.28±6.24 dB。经角膜电刺激前后眼压未观察到显著差异。然而,MD值的变化与经角膜电刺激治疗次数之间存在显著的正线性关系(R = 0.176,P = 0.005,Spearman相关性R = 0.294,P = 0.008)。经角膜电刺激治疗可能改善原发性开角型青光眼患者的青光眼性视野缺损。需要进行大规模研究来证实这些初步发现。

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