Graham S L, Goldberg I, Buckland L, Hollows F C
Eye Clinic, Prince of Wales Hospital, Randwick, Australia.
Exp Eye Res. 1995 Jun;60(6):697-706. doi: 10.1016/s0014-4835(05)80011-9.
We investigated recent reports that, contrary to common belief, glaucoma can affect flash as well as pattern electroretinograms. An extensive flash and pattern electroretinogram test protocol was used in a large sample of glaucoma patients and age-matched controls who were either visually normal or had other optic nerve diseases. All electroretinogram parameters were reduced and delayed in normal people > 55 years of age. The effect did not increase in later decades. In patients aged < or = 55 years, flash electroretinograms showed mild reductions and delays from optic atrophy alone. Glaucomatous ERG changes were larger and increased with disease severity. Pattern electroretinograms and oscillatory potentials were almost equally reduced in optic atrophy and all degrees of glaucoma. Mildly affected patients > 55 years of age had similar electroretinogram change to age-matched normals in most conditions. Advanced glaucoma patients showed similar differences from normal irrespective of age. This suggests that direct diagnostic application of these results to older patients will be difficult, that the ERG changes in glaucoma cannot be attributed simply to optic atrophy and that additional widespread outer retinal damage occurs in glaucoma.
我们对近期的一些报告进行了调查，这些报告指出，与普遍看法相反，青光眼不仅会影响图形视网膜电图，还会影响闪光视网膜电图。我们在大量青光眼患者以及年龄匹配的对照组（这些人视力正常或患有其他视神经疾病）中采用了广泛的闪光和图形视网膜电图测试方案。所有视网膜电图参数在55岁以上的正常人中均有所降低且出现延迟。在随后的几十年中，这种影响并未增强。在年龄小于或等于55岁的患者中，闪光视网膜电图仅因视神经萎缩而出现轻度降低和延迟。青光眼性视网膜电图的变化更大，且随疾病严重程度增加。在视神经萎缩和所有程度的青光眼中，图形视网膜电图和振荡电位的降低几乎相同。在大多数情况下，55岁以上轻度受影响的患者与年龄匹配的正常人有相似的视网膜电图变化。无论年龄大小，晚期青光眼患者与正常人都有相似的差异。这表明将这些结果直接应用于老年患者进行诊断会很困难，青光眼患者的视网膜电图变化不能简单地归因于视神经萎缩，并且青光眼还会发生额外的广泛外层视网膜损伤。
