Abdelshafy Marwa, Abdelshafy Ahmed
Ophthalmology Department, Benha University, Benha, Egypt.
Clin Ophthalmol. 2020 Feb 12;14:397-404. doi: 10.2147/OPTH.S235892. eCollection 2020.
To assess the functional and structural changes in the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC) in heavy smokers using pattern electroretinogram (PERG), photopic negative response(PhNR) and spectral domain optical coherence tomography (SD-OCT).
Sixty eyes of 30 heavy smokers (at least 15 cigarettes/day for 10 years) (study group) and 60 eyes of 30 age and gender-matched healthy non-smoker subjects (control group) were included. After full ophthalmologic examination (PERG), (PhNR) using RETI-port/scan 21 (Roland Consult, Brandenburg, Germany) and (SD-OCT using Topcon 3D OCT model 2000 FA version.8.30) were tested for all participants. Statistical analysis was performed to compare GCC, RNFL thicknesses, PERG and phNR values between groups.
The mean age was 36.67±4.13 years in the study group and 36.0±4.76 years in the control group. There were no statistical significant differences between the two groups regarding intraocular pressure (p=0.43), axial length (p=0.37), and central corneal thickness (p=0.86). There were significant differences of GCC thickness values between the study group (88.4±6.6 µm) and control group (94.83±5.25 µm) (p<0.001). The mean RNFL values of study and control groups were 97.87±5.88 and 106.43±6.59 µm, respectively (p<0.001). In the study group the superior and inferior quadrants of RNFL were significantly thinner, but there were no significant differences between the two groups in nasal and temporal quadrants. There were no significant differences of PERG-P50 amplitude (p=0.49) and latency (p=0.71); however, PERG-N95 amplitude and latency showed significant differences between the two groups (p<0.001).There were significant differences of phNR amplitude and latency between the two groups (p<0.001). Multiple regression analyses demonstrated that the PhNR, PERG amplitude and latency are the most important determinants for both RNFL and GCC thicknesses.
In heavy smokers RNFL thickness was decreased, the PhNR, PERG-N95 amplitudes were diminished and the implicit times were prolonged compared to non-smokers. PhNR and PERG reflect both dysfunction and loss of ganglion cells and their axons.
使用图形视网膜电图（PERG）、明视负反应（PhNR）和频域光学相干断层扫描（SD-OCT）评估重度吸烟者视网膜神经纤维层（RNFL）和神经节细胞复合体（GCC）的功能和结构变化。
纳入30名重度吸烟者（至少15支/天，持续10年）的60只眼（研究组）和30名年龄及性别匹配的健康非吸烟者的60只眼（对照组）。所有参与者均接受全面眼科检查（PERG），使用RETI-port/scan 21（德国勃兰登堡罗兰咨询公司）进行（PhNR）检查，并使用拓普康3D OCT 2000 FA版8.30型号进行（SD-OCT）检查。进行统计分析以比较两组之间的GCC、RNFL厚度、PERG和PhNR值。
研究组平均年龄为36.67±4.13岁，对照组为36.0±4.76岁。两组在眼压（p = 0.43）、眼轴长度（p = 0.37）和中央角膜厚度（p = 0.86）方面无统计学显著差异。研究组（88.4±6.6 µm）与对照组（94.83±5.25 µm）的GCC厚度值存在显著差异（p<0.001）。研究组和对照组的RNFL平均厚度分别为97.87±5.88和106.43±6.59 µm（p<0.001）。研究组RNFL的上象限和下象限明显变薄，但两组在鼻侧象限和颞侧象限无显著差异。PERG-P50波幅（p = 0.49）和潜伏期（p = 0.71）无显著差异；然而，PERG-N95波幅和潜伏期在两组之间存在显著差异（p<0.001）。两组之间的PhNR波幅和潜伏期存在显著差异（p<0.001）。多元回归分析表明，PhNR、PERG波幅和潜伏期是RNFL和GCC厚度的最重要决定因素。
与非吸烟者相比，重度吸烟者的RNFL厚度降低，PhNR、PERG-N95波幅减小，潜伏期延长。PhNR和PERG反映了神经节细胞及其轴突的功能障碍和丧失。
