Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto.
Department of Ophthalmology and Visual Science, Federal University of São Paulo, São Paulo, SP, Brazil.
J Glaucoma. 2020 Feb;29(2):147-153. doi: 10.1097/IJG.0000000000001422.
Electrophysiological testing of the visual system has been continuously used in studies involving the evaluation of retinal ganglion cells and the diagnosis of glaucoma. This study aims to review the results of recent studies regarding the clinical applicability of electrophysiological tests to glaucoma.
A systematic review of the literature was carried out by 2 independent reviewers using the PubMed and EMBASE electronic databases, searching for articles published in English from January 1, 2014 to July 1, 2019 using a combination of the following keywords: ("glaucoma" OR "ocular hypertension") AND ("electrophysiolog" OR "electroretinogra" OR "ERG" OR "mfERG" OR "Pattern-reversal electroretinography" OR "PERG" OR "mfPERG" OR "photopic negative response" OR "pattern electroretinogram" OR "visual evoked potential" OR "multifocal electroretinography" OR "multifocal electroretinogram" OR "electro-oculography" OR "multifocal VEP" OR "mf-ERG"). A total of 38 studies were selected and the data of 30 of them were tabulated in this review.
Among the 30 studies selected, the photopic negative response and the reversal pattern electroretinogram were found to be the major methods used to record the electroretinographic responses generated by the retinal ganglion cell. Their multifocal versions and the multifocal visual evoked potential were also proposed during this period. In general, the results underscored a consistent but general correlation between the amplitude and latency measures and routine tests for glaucoma, such as perimetry and optical coherence tomography.
In agreement with previous reviews, clinical electrophysiological testing of the visual system reasonably matched with both the structural and functional analyses for glaucoma. No definitive indications of these tests have been established either at early detection or during follow-up of the disease, and easier protocols and better topographical correspondence with current glaucoma tests are warranted for their routine use.
视觉系统的电生理测试已在涉及视网膜神经节细胞评估和青光眼诊断的研究中得到持续应用。本研究旨在回顾最近关于电生理测试在青光眼临床应用的研究结果。
两名独立评审员使用 PubMed 和 EMBASE 电子数据库进行系统文献回顾，使用以下关键词的组合在 2014 年 1 月 1 日至 2019 年 7 月 1 日期间搜索发表的英文文章：（“青光眼”或“高眼压症”）和（“电生理”或“视网膜电流图”或“ERG”或“mfERG”或“图形反转视网膜电流图”或“PERG”或“mfPERG”或“光负反应”或“图形视网膜电图”或“视觉诱发电位”或“多焦视网膜电图”或“多焦视网膜电图”或“眼动电图”或“多焦 VEP”或“mf-ERG”）。共选择了 38 项研究，其中 30 项研究的数据在本综述中进行了制表。
在所选择的 30 项研究中，发现光负反应和反转图形视网膜电流图是记录视网膜神经节细胞产生的视网膜电流反应的主要方法。在此期间，还提出了它们的多焦版本和多焦视觉诱发电位。总体而言，结果强调了振幅和潜伏期测量值与青光眼常规测试（如视野检查和光学相干断层扫描）之间的一致性，但存在一般性关联。
与之前的综述一致，视觉系统的临床电生理测试与青光眼的结构和功能分析相当匹配。这些测试在早期检测或疾病随访中均未确立明确的适应症，并且需要更简单的方案和更好的与当前青光眼测试的拓扑对应关系，以便常规使用。
