Parisi Vincenzo, Ziccardi Lucia, Tanga Lucia, Roberti Gloria, Barbano Lucilla, Carnevale Carmela, Manni Gianluca, Oddone Francesco
IRCCS-Fondazione Bietti, Rome, Italy.
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
Front Aging Neurosci. 2021 Aug 2;13:697425. doi: 10.3389/fnagi.2021.697425. eCollection 2021.
: This study was conducted in order to evaluate retinal ganglion cell (RCG) function and the neural conduction along the postretinal large and small axons and its correlation with retinal nerve fiber layer thickness (RNFL-T) in open-angle glaucoma (OAG) eyes. : Thirty-seven OAG patients (mean age: 51.68 ± 9.83 years) with 24-2 Humphrey mean deviation (MD) between -2.5 and -20 dB and IOP <21 mmHg on pharmacological treatment (OAG group) and 20 age-matched controls (control group) were enrolled. In both groups, simultaneous pattern electroretinograms (PERG) and visual evoked potentials (VEP), in response to checks stimulating macular or extramacular areas (the check edge subtended 15' and 60' of visual arc, respectively), and RNFL-T (measured in superior, inferior, nasal, and temporal quadrants) were assessed. : In the OAG group, a significant (ANOVA, < 0.01) reduction of 60' and 15' PERG P50-N95 and VEP N75-P100 amplitudes and of RNFL-T [overall (average of all quadrants) or temporal] with respect to controls was found; the values of 60' and 15' PERG P50 and VEP P100 implicit times and of retinocortical time (RCT; difference between VEP P100 and PERG P50 implicit times) were significantly ( < 0.01) increased with respect to control ones. The observed increased RCTs were significantly linearly correlated (Pearson's test, < 0.01) with the reduced PERG amplitude and MD values, whereas no significant linear correlation ( < 0.01) with RNFL-T (overall or temporal) values was detected. : In OAG, there is an impaired postretinal neural conduction along both large and small axons (increased 60' and 15' RCTs) that is related to RGC dysfunction, but independent from the RNFL morphology. This implies that, in OAG, the impairment of postretinal neural structures can be electrophysiologically identified and may contribute to the visual field defects, as suggested by the linear correlation between the increase of RCT and MD reduction.
本研究旨在评估开角型青光眼(OAG)患者视网膜神经节细胞(RGC)功能、视网膜后大、小轴突的神经传导情况及其与视网膜神经纤维层厚度(RNFL-T)的相关性。纳入37例OAG患者(平均年龄:51.68±9.83岁),其24-2 Humphrey平均偏差(MD)在-2.5至-20 dB之间,药物治疗时眼压<21 mmHg(OAG组),以及20例年龄匹配的对照者(对照组)。两组均进行了同步图形视网膜电图(PERG)和视觉诱发电位(VEP)检查,刺激黄斑或黄斑外区域的方格(方格边缘分别对应15'和60'视弧),并评估RNFL-T(在上、下、鼻、颞象限测量)。在OAG组中,发现与对照组相比,60'和15' PERG的P50-N95以及VEP的N75-P100波幅和RNFL-T[总体(所有象限平均值)或颞侧]显著降低(方差分析,<0.01);60'和15' PERG的P50以及VEP的P100潜伏期和视皮质时间(RCT;VEP P100与PERG P50潜伏期之差)与对照组相比显著增加(<0.01)。观察到的RCT增加与PERG波幅降低和MD值显著线性相关(Pearson检验,<0.01),而与RNFL-T(总体或颞侧)值无显著线性相关(<0.01)。在OAG中,视网膜后大、小轴突的神经传导均受损(60'和15' RCT增加),这与RGC功能障碍有关,但与RNFL形态无关。这意味着,在OAG中,视网膜后神经结构的损伤可通过电生理方法识别,并且可能导致视野缺损,RCT增加与MD降低之间的线性相关性表明了这一点。