Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki Prefecture, 889-1692, Japan.
Graefes Arch Clin Exp Ophthalmol. 2024 Jan;262(1):161-169. doi: 10.1007/s00417-023-06193-z. Epub 2023 Aug 3.
To investigate the objective function of the inner retinal layer in each stage of primary open angle glaucoma (POAG) using the photopic negative response (PhNR) measured by RETeval full-field electroretinography (ERG), and to identify which PhNR parameter is the most useful.
Ninety eyes of 90 patients with POAG (30 with mild POAG (mean deviation (MD) ≥ -6 dB) and 60 with moderate-to-advanced POAG (MD < -6 dB)) and 76 eyes of 76 control cases were examined. We investigated six PhNR parameters and their relationships with the results of the Humphrey 30-2 visual field test and the thickness of the circumpapillary retinal nerve fiber layer (cpRNFL) obtained from optical coherence tomography. The following PhNR parameters were assessed: base-to-trough (BT), peak-to-trough (PT), 72msPhNR, the W-ratio, P-ratio, implicit time (IT), and a-wave and b-wave amplitudes on ERG.
All PhNR parameters other than IT significantly differed between the all POAG (all stages) and control groups and between the moderate-to-advanced POAG and control groups. BT and 72msPhNR in the mild POAG group, significantly differed from those in the control group. Regarding the relationships between PhNR parameters and the visual field and between these parameters and cpRNFL thickness, correlations were observed between all PhNR parameters, except PT and IT, and both the visual field and cpRNFL thickness in the all and moderate-to-advanced POAG groups. 72msPhNR correlated with cpRNFL thickness in the mild POAG group. The area under the receiver operating characteristic curve was greater for BT than for the other PhNR parameters in both the mild and moderate-to-advanced POAG groups. The discriminant linear function for examining the presence or absence of POAG and the threshold for diagnosis were quantitatively obtained as follows. Regarding BT: discriminant = 0.505 × BT + 2.017; threshold = positive for POAG, negative for no POAG; correct answer rate = 80.7%. Concerning 72msPhNR: discriminant = 0.533 × 72msPhNR + 1.553; threshold = positive for POAG and negative for no POAG; correct answer rate = 77.1%.
RETeval-measured PhNR parameters were useful for an objective evaluation of visual function in moderate-to-advanced POAG. BT appeared to be the most diagnostically useful parameter.
使用 RETeval 全视野视网膜电图（ERG）测量的光峰负反应（PhNR），探讨原发性开角型青光眼（POAG）各期内层视网膜的目标函数，并确定哪个 PhNR 参数最有用。
对 90 例 90 只眼的 POAG 患者（30 例轻度 POAG（平均偏差（MD）≥-6 dB）和 60 例中重度至晚期 POAG（MD <-6 dB））和 76 例对照组 76 只眼进行检查。我们研究了六个 PhNR 参数及其与 Humphrey 30-2 视野测试结果和光学相干断层扫描（OCT）获得的环周视网膜神经纤维层（cpRNFL）厚度的关系。评估了以下 PhNR 参数：基底到谷（BT）、峰到谷（PT）、72msPhNR、W 比、P 比、潜伏期（IT）和 ERG 的 a 波和 b 波振幅。
除 IT 外，所有 PhNR 参数在所有 POAG（所有阶段）和对照组以及中重度至晚期 POAG 和对照组之间均有显著差异。轻度 POAG 组的 BT 和 72msPhNR 与对照组有显著差异。关于 PhNR 参数与视野之间的关系以及这些参数与 cpRNFL 厚度之间的关系，所有 PhNR 参数（PT 和 IT 除外）与所有 POAG 和中重度至晚期 POAG 组的视野和 cpRNFL 厚度均呈相关性。72msPhNR 与轻度 POAG 组的 cpRNFL 厚度相关。BT 的受试者工作特征曲线下面积大于其他 PhNR 参数，无论是在轻度还是中重度至晚期 POAG 组。定量获得了用于检查 POAG 是否存在以及诊断阈值的判别线性函数，如下所示。关于 BT：判别=0.505×BT+2.017；阈值=POAG 阳性，无 POAG 阴性；正确答案率=80.7%。关于 72msPhNR：判别=0.533×72msPhNR+1.553；阈值=POAG 阳性，无 POAG 阴性；正确答案率=77.1%。
使用 RETeval 测量的 PhNR 参数可用于客观评估中重度至晚期 POAG 的视觉功能。BT 似乎是最具诊断价值的参数。
