State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
School of Computer Science and Engineering, Sun Yat-Sen University, Guangzhou, China.
Br J Ophthalmol. 2022 Nov;106(11):1530-1537. doi: 10.1136/bjophthalmol-2021-318972. Epub 2021 May 24.
BACKGROUND/AIMS: We aimed to explore the impact of glaucomatous macular damage, specifically retinal ganglion cell (RGC) loss, on macular pattern vision measured by the vanishing optotype (VO) recognition contrast threshold.
Seventy-two patients (mean age, 33.51±7.05 years) with primary open-angle glaucoma and 36 healthy controls (mean age, 30.25±6.70 years) were enrolled. VO recognition contrast thresholds of each participant were measured at the 16 preset test locations covering the central 5° visual field (VF). Macular sensitivity (MS) was tested by macular threshold test of Humphrey Field Analyzer. Macular RGC plus inner plexiform layer (GCIPL) thickness was also measured by spectral domain optical coherence tomography.
The VO contrast threshold demonstrated weak-to-moderate correlations (rho=-0.275 to -0.653) with MS (p<0.001). There was a significantly higher VO contrast threshold in glaucoma group (p<0.0001). At similar levels of MS, patients with glaucoma with GCIPL damage showed remarkably higher VO contrast thresholds than those with preserved GCIPL (p=0.0079). The structure-function relationships between VO contrast threshold and GCIPL thickness (rho=-0.725 to -0.802) were remarkably stronger than those between MS and GCIPL thickness (rho=0.210 to 0.448). VO contrast threshold showed stronger correlation with average GCIPL thickness (rho=-0.362 to -0.778) than MS (rho=0.238 to 0.398) at multiple test locations in glaucoma group.
Glaucomatous eyes have higher contrast thresholds for VO recognition in fovea-around VF. Stronger structure-function relationships indicate that VO contrast threshold is more vulnerable to RGC damage.
背景/目的：我们旨在探讨青光眼性黄斑损伤，特别是视网膜神经节细胞（RGC）丢失，对视场中央 5°范围内黄斑图形视觉（以视标消失法识别对比度阈值测量）的影响。
纳入 72 例（平均年龄 33.51±7.05 岁）原发性开角型青光眼患者和 36 名健康对照者（平均年龄 30.25±6.70 岁）。使用视标消失法在 16 个预设测试位置测量每位参与者的识别对比度阈值，这些位置覆盖了中央 5°视野（VF）。使用 Humphrey 视野分析仪检测黄斑敏感度（MS）。还通过频域光学相干断层扫描测量黄斑神经节细胞加内丛状层（GCIPL）厚度。
视标消失法对比度阈值与 MS 呈弱至中度相关（rho=-0.275 至-0.653，p<0.001）。青光眼组的视标消失法对比度阈值显著更高（p<0.0001）。在相似的 MS 水平下，GCIPL 损伤的青光眼患者的视标消失法对比度阈值明显高于 GCIPL 保留的患者（p=0.0079）。视标消失法对比度阈值与 GCIPL 厚度之间的结构-功能关系（rho=-0.725 至-0.802）明显强于 MS 与 GCIPL 厚度之间的关系（rho=0.210 至 0.448）。在青光眼组的多个测试位置，视标消失法对比度阈值与平均 GCIPL 厚度的相关性（rho=-0.362 至-0.778）强于 MS（rho=0.238 至 0.398）。
青光眼患者在视场中央 5°范围内的视标消失法识别对比阈值较高。更强的结构-功能关系表明，视标消失法对比度阈值对 RGC 损伤更为敏感。
