Trick G L, Bickler-Bluth M, Cooper D G, Kolker A E, Nesher R
Department of Ophthalmology, Washington University School of Medicine, St. Louis, MO 63110.
Curr Eye Res. 1988 Feb;7(2):201-6. doi: 10.3109/02713688808995749.
The indices employed commonly for the diagnosis of glaucoma (tonometry, ophthalmoscopy and perimetry) do not always identify which patients with ocular hypertension (OHT) will develop primary open-angle glaucoma (POAG) before irreversible visual field loss is manifest (1). The human pattern reversal electroretinogram (PRERG) is a bioelectric response reflecting neural activity of the proximal retina. PRERG amplitude reductions have been observed in POAG and other diseases affecting the optic nerve and retinal ganglion cells. This study was designed to determine whether OHT patients exhibit PRERG amplitude reductions and whether PRERG results are correlated with routinely evaluated clinical parameters. Steady-state PRERG (16 rps) were elicited by high contrast (76%), phase alternating checkerboard patterns (15-20 min checks) from one eye of 130 patients with ocular hypertension and 47 age matched visual normals (AMVNs). A significant (p less than 0.05) reduction in PRERG amplitude was noted for the OHT patients and 11.5% of those patients exhibited PRERG amplitudes more than 2.0 standard deviations below the AMVN mean. PRERG amplitude was found to be positively correlated with diastolic blood pressure (DBP) and negatively correlated with age, but no correlation between PRERG amplitude and either IOP, C/D ratio, or systolic blood pressure was evident. The lack of correlation between PRERG amplitude and the commonly used clinical indices may suggest a complementary role for this neurophysiologic test in determining which OHT patients will develop glaucoma.
常用于青光眼诊断的指标（眼压测量、检眼镜检查和视野检查）并不总能识别出哪些高眼压症（OHT）患者在出现不可逆视野缺损之前会发展为原发性开角型青光眼（POAG）(1)。人类图形翻转视网膜电图（PRERG）是一种反映近端视网膜神经活动的生物电反应。在POAG以及其他影响视神经和视网膜神经节细胞的疾病中，已观察到PRERG振幅降低。本研究旨在确定高眼压症患者是否存在PRERG振幅降低，以及PRERG结果是否与常规评估的临床参数相关。通过高对比度（76%）、相位交替棋盘格图案（15 - 20分钟检查），对130例高眼压症患者的一只眼睛和47例年龄匹配的视力正常者（AMVN）进行稳态PRERG（16转/秒）检测。高眼压症患者的PRERG振幅显著降低（p小于0.05），其中11.5%的患者PRERG振幅比AMVN平均值低2.0个标准差以上。发现PRERG振幅与舒张压（DBP）呈正相关，与年龄呈负相关，但PRERG振幅与眼压、杯盘比或收缩压之间均无明显相关性。PRERG振幅与常用临床指标之间缺乏相关性，这可能表明该神经生理学检测在确定哪些高眼压症患者会发展为青光眼方面具有补充作用。
