Institute of Ophthalmology, University College London, 11-43 Bath Street, London, UK.
Retinal and Genetics Services, Moorfields Eye Hospital, 162 City Road, London, UK.
Eye (Lond). 2023 Aug;37(12):2399-2408. doi: 10.1038/s41433-023-02491-2. Epub 2023 Mar 16.
Visual electrophysiology affords direct, quantitative, objective assessment of visual pathway function at different levels, and thus yields information complementary to, and not necessarily obtainable from, imaging or psychophysical testing. The tests available, and their indications, have evolved, with many advances, both in technology and in our understanding of the neural basis of the waveforms, now facilitating more precise evaluation of physiology and pathophysiology. After summarising the visual pathway and current standard clinical testing methods, this review discusses, non-exhaustively, several developments, focusing particularly on human electroretinogram recordings. These include new devices (portable, non-mydiatric, multimodal), novel testing protocols (including those aiming to separate rod-driven and cone-driven responses, and to monitor retinal adaptation), and developments in methods of analysis, including use of modelling and machine learning. It is likely that several tests will become more accessible and useful in both clinical and research settings. In future, these methods will further aid our understanding of common and rare eye disease, will help in assessing novel therapies, and will potentially yield information relevant to neurological and neuro-psychiatric conditions.
视觉电生理学提供了对视觉通路功能的直接、定量、客观评估,可提供与成像或心理物理测试互补的信息,而不一定能从这些测试中获得。随着技术的进步和我们对波形神经基础的理解的提高,可用的测试及其适应证不断发展,现在更便于更精确地评估生理学和病理生理学。在总结了视觉通路和当前标准的临床测试方法后,本文讨论了几个进展,重点讨论了人类视网膜电图记录,包括新设备(便携式、非接触式、多模态)、新的测试方案(包括旨在分离杆状细胞驱动和锥状细胞驱动反应以及监测视网膜适应的方案)以及分析方法的发展,包括使用建模和机器学习。将来,这些测试将在临床和研究环境中变得更加容易获得和有用。这些方法将有助于我们进一步了解常见和罕见眼病,帮助评估新疗法,并可能提供与神经和神经精神疾病相关的信息。