Ruben S T, Arden G B, O'Sullivan F, Hitchings R A
Electrodiagnostic Department, Moorfields Eye Hospital, London.
Br J Ophthalmol. 1995 Apr;79(4):326-31. doi: 10.1136/bjo.79.4.326.
Both pattern electroretinogram and peripheral colour contrast thresholds have been shown to be abnormal in glaucoma and ocular hypertension. This study evaluates each of these tests as tools for the early diagnosis of glaucoma, compares and contrasts the results, and examines the relation between the two tests in a large cohort of ocular hypertensive patients.
Transient and steady state pattern electroretinograms and peripheral colour contrast thresholds were performed in 45 normal, 37 glaucomatous, and 206 ocular hypertensive eyes. The results were analysed using receiver operating characteristic curves, together with evaluation of sensitivity and specificity of the tests. The relation between the two tests was examined by direct statistical correlation of the results.
All tests showed high sensitivity and specificity for discriminating between normal and glaucomatous eyes. However, there was a significant difference between the two tests for the number of ocular hypertensives considered as abnormal. Forty per cent of ocular hypertensives had abnormal pattern electroretinogram compared with 30% with abnormal peripheral colour vision. Peripheral colour contrast thresholds showed a significant correlation with both transient and steady state pattern electroretinogram.
Both of these tests have been shown to be promising new tools for the early detection of glaucoma but the number of ocular hypertensive patients showing abnormal results is rather higher than expected considering the natural history of the condition. Sensitivity in ocular hypertension may be increased by using a combination of both tests. The significant correlation between these psychophysical and electrophysiological tests is discussed.
在青光眼和高眼压症中,图形视网膜电图和周边颜色对比阈值均已显示异常。本研究评估这两项检查作为青光眼早期诊断工具的情况,比较并对比结果,并在一大群高眼压症患者中研究这两项检查之间的关系。
对45只正常眼、37只青光眼眼和206只高眼压症眼进行了瞬态和稳态图形视网膜电图以及周边颜色对比阈值检查。使用受试者工作特征曲线分析结果,并评估检查的敏感性和特异性。通过对结果进行直接统计相关性分析来研究这两项检查之间的关系。
所有检查在区分正常眼和青光眼眼方面均显示出高敏感性和特异性。然而,对于被视为异常的高眼压症患者数量,这两项检查之间存在显著差异。40%的高眼压症患者图形视网膜电图异常,而周边色觉异常的患者为30%。周边颜色对比阈值与瞬态和稳态图形视网膜电图均显示出显著相关性。
这两项检查均已被证明是青光眼早期检测的有前景的新工具,但考虑到病情的自然史,显示异常结果的高眼压症患者数量高于预期。联合使用这两项检查可能会提高高眼压症的检测敏感性。讨论了这些心理物理学和电生理学检查之间的显著相关性。