Neuroscience, The John Curtin School of Medical Research, Australian National University, Building 131 Garran Road, Canberra ACT, 2601, Australia.
CERA Retinal Gene Therapy Unit, University of Melbourne, Melbourne Vic, Australia.
BMC Ophthalmol. 2024 Apr 10;24(1):159. doi: 10.1186/s12886-024-03402-z.
Multifocal pupillographic objective perimetry (mfPOP) is a novel method for assessing functional change in diseases like glaucoma. Previous research has suggested that, in contrast to the pretectally-mediated melanopsin response of intrinsically photosensitive retinal ganglion cells, mfPOP responses to transient onset stimuli involve the extrastriate cortex, and thus the main visual pathway. We therefore investigate the correlation between peripapillary retinal nerve fibre layer (pRNFL) thickness and glaucomatous visual field changes detected using mfPOP. Parallel analyses are undertaken using white on white standard automated perimetry (SAP) for comparison.
Twenty-five glaucoma patients and 24 normal subjects were tested using SAP, 3 mfPOP variants, and optical coherence tomography (OCT). Arcuate clusters of the SAP and mfPOP deviations were weighted according to their contribution to published arcuate divisions of the retinal nerve fibre layer. Structure-function correlation coefficients (r) were computed between pRNFL clock-hour sector thickness measurements, and the local visual field sensitivities from both SAP and mfPOP.
The strongest correlation was observed in the superior-superotemporal disc sector in patients with worst eye SAP MD < -12 dB: r = 0.93 for the mfPOP LumBal test (p < 0.001). Correlations across all disc-sectors were strongest in these same patients in both SAP and mfPOP: SAP r = 0.54, mfPOP LumBal r = 0.55 (p < 0.001). In patients with SAP MD ≥ -6 dB in both eyes, SAP correlations across all sectors were higher than mfPOP; mfPOP correlations however, were higher than SAP in more advanced disease, and in normal subjects.
For both methods the largest correlations with pRNFL thickness corresponded to the inferior nasal field of more severely damaged eyes. Head-to-head comparison of mfPOP and SAP showed similar structure-function relationships. This agrees with our recent reports that mfPOP primarily stimulates the cortical drive to the pupils.
多焦瞳孔客观视野计（mfPOP）是一种评估青光眼等疾病功能变化的新方法。先前的研究表明，与内在光敏视网膜神经节细胞的前脑介导的黑视素反应相比，mfPOP 对瞬态起始刺激的反应涉及外纹状皮层，因此涉及主要视觉通路。因此，我们研究了mfPOP 检测到的视盘周围视网膜神经纤维层（pRNFL）厚度与青光眼视野变化之间的相关性。为了进行比较，还进行了使用白对白标准自动视野计（SAP）的平行分析。
使用 SAP、3 种 mfPOP 变体和光学相干断层扫描（OCT）对 25 名青光眼患者和 24 名正常受试者进行了测试。根据它们对已发表的视网膜神经纤维层弧形分区的贡献，对 SAP 和 mfPOP 偏差的弧形簇进行加权。计算了 pRNFL 时钟小时区厚度测量值与 SAP 和 mfPOP 的局部视野敏感度之间的结构-功能相关系数（r）。
在 SAP MD < -12 dB 的最差眼患者的上-上颞盘区观察到最强的相关性：mfPOP LumBal 测试 r = 0.93（p < 0.001）。在所有盘区中，在 SAP 和 mfPOP 中，这些相同患者的相关性最强：SAP r = 0.54，mfPOP LumBal r = 0.55（p < 0.001）。在双眼 SAP MD ≥ -6 dB 的患者中，SAP 与所有盘区的相关性高于 mfPOP；然而，在更严重的疾病和正常受试者中，mfPOP 的相关性高于 SAP。
对于两种方法，与 pRNFL 厚度的最大相关性对应于更严重受损眼睛的下鼻侧视野。mfPOP 和 SAP 的头对头比较表明，结构-功能关系相似。这与我们最近的报道一致，即 mfPOP 主要刺激瞳孔的皮质驱动。
