慢性青光眼中Diopsys®短持续时间瞬态视觉诱发电位潜伏期与视野进展的相关性
Association of Diopsys® Short-duration Transient Visual Evoked Potential Latency with Visual Field Progression in Chronic Glaucoma.
作者信息
Trevino Richard, Sponsel William E, Majcher Carolyn E, Allen Joey, Rabin Jeffery
机构信息
Optometrist, Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, Texas, USA.
Director, Professor and Consultant, Department of Ophthalmology, CLI Eyes of Africa Clinic and Surgery Center, Malawi, Africa; WESMDPA Baptist Medical Center Glaucoma Service, San Antonio, Texas; Department of Biomedical Engineering, University of Texas San Antonio, San Antonio, Texas; Rosenberg School of Optometry, University of the Incarnate Word, San Antonio, Texas, USA.
出版信息
J Curr Glaucoma Pract. 2018 Jan-Apr;12(1):29-35. doi: 10.5005/jp-journals-10028-1240. Epub 2018 Mar 1.
AIM
To determine the association of Diopsys® NOVA-LX amplitude and latency abnormality scores with perimetric staging of chronic glaucoma, and to explore potential single-visit short-duration transient visual evoked potential (SD-tVEP) trend detection ability utilizing Humphrey 30-2 field progression data.
MATERIALS AND METHODS
Glaucoma subspecialty clinic. Treated adult chronic glaucoma patients undergoing SD-tVEP evaluation. (1) Proportion of eyes designated as suspect or abnormal by the NOVA-LX multifactorial algorithm were determined as a function of glaucoma severity using the most recent Humphrey visual field analyzer (HVFA) 30-2 field. (2) Association between long-term HVFA-guided progression analysis (GPA) annual slopes and SD-tVEP abnormality was assessed to determine whether a single VEP test might help to identify eyes more prone to progressive visual field (VF) loss.
RESULTS
One hundred and thirty-three eyes of 84 patients (mean age 68 years) were analyzed. The SD-tVEP abnormality increased proportionately with severity of VF loss under high-contrast (Hc) test conditions for both latency (p = 0.001) and amplitude (p < 0.01). The HVFA progression analysis printouts existed for 91 eyes (mean 12.3 fields per eye/range 5-18). Nearly three-quarters (72.5%) of eyes with mean annual HVFA progression >0.7 dB/year (n = 29) had single-visit VEP latency abnormalities. Fewer than half (46.7%) of the remainder (n = 62) showed latency abnormality. Mean progression for eyes with abnormal normal VEP latency was -0.87 ± 0.3 dB/year -0.32 ± 0.4 dB/year.
CONCLUSION
Diopsys NOVA-LX Hc latency abnormality shows strong association with VF loss among a diverse population of clinical patients undergoing active treatment for chronic glaucoma, and appears likely to afford clinically useful trend-detecting test.
CLINICAL SIGNIFICANCE
The SD-tVEP has the potential to serve as a single-visit clinical indicator to identify glaucoma patients at high risk for VF progression. Trevino R, Sponsel WE, Majcher CE, Allen J, Rabin J. Association of Diopsys® Short-duration Transient Visual Evoked Potential Latency with Visual Field Progression in Chronic Glaucoma. J Curr Glaucoma Pract 2018;12(1):29-35.
目的
确定Diopsys® NOVA-LX振幅和潜伏期异常评分与慢性青光眼视野分期之间的关联，并利用Humphrey 30-2视野进展数据探索单次短持续时间瞬态视觉诱发电位（SD-tVEP）趋势检测的潜在能力。
材料与方法
青光眼专科诊所。接受SD-tVEP评估的成年慢性青光眼患者。（1）使用最新的Humphrey视野分析仪（HVFA）30-2视野，根据青光眼严重程度确定被NOVA-LX多因素算法判定为可疑或异常的眼睛比例。（2）评估长期HVFA引导的进展分析（GPA）年度斜率与SD-tVEP异常之间的关联，以确定单次VEP测试是否有助于识别更容易发生视野（VF）丧失的眼睛。
结果
分析了84例患者（平均年龄68岁）的133只眼睛。在高对比度（Hc）测试条件下，潜伏期（p = ０.００１）和振幅（p < ０.０１）的SD-tVEP异常均与VF丧失的严重程度成比例增加。91只眼睛有HVFA进展分析打印结果（每只眼睛平均12.3次视野/范围5-18次）。平均年度HVFA进展>０.７ dB/年的眼睛中近四分之三（72.5%，n = 29）单次VEP潜伏期异常。其余眼睛（n = 62）中不到一半（46.7%）显示潜伏期异常。VEP潜伏期异常与正常的眼睛的平均进展分别为-０.８７±０.３ dB/年和-０.３２±０.４ dB/年。
结论
在接受慢性青光眼积极治疗的不同临床患者群体中，Diopsys NOVA-LX Hc潜伏期异常与VF丧失密切相关，并且似乎可能提供临床上有用的趋势检测测试。
临床意义
SD-tVEP有可能作为单次临床指标，以识别有VF进展高风险的青光眼患者。Trevino R，Sponsel WE，Majcher CE，Allen J，Rabin J。Diopsys®短持续时间瞬态视觉诱发电位潜伏期与慢性青光眼视野进展的关联。《当代青光眼实践杂志》2018；12（1）：29-35。
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