Kremmer S, Tolksdorf-Kremmer A, Stodtmeister R
Universitätsaugenklinik Essen, Deutschland.
Ophthalmologica. 1995;209(5):233-41. doi: 10.1159/000310622.
The visual evoked cortical potentials (VECP) are changed by the artificial increase in intraocular pressure (IOP). The exact location of the damage is still unclear. One possibility is that the increased ocular pressure reduces the blood flow in the optic nerve head. The function of the optic nerve fiber function would be decreased by this effect. Another possibility is that the generation of the signals in the retinal ganglion cells could be influenced by the artificial pressure enhancement. We developed a method of simultaneous recording pattern reversal electroretinograms (PERG) and VECP during artificially raised IOP. The PERG was recorded by cutaneous electrodes (Grass, USA; diameter 5 mm), which were positioned close to the lid margins. The pattern reversal rate was 7.9 reversals/s. In a pilot study, we examined 10 healthy volunteers with artificially increased ocular pressure. In 9 cases, amplitudes showed a more stable behavior in the VECP than in the PERG: the mathematical behavior of the amplitude/pressure curves was more stable in the VECP of 6 volunteers and once in the PERG. Signs of very sufficient autoregulation could be found in the VECP of 7 volunteers and once in the PERG. The critical pressure, at which a further increase in IOP causes a continuous amplitude decrease to the noise level, was 9 times more stable in VECP (median 53 mmHg) than in PERG (median 48 mmHg). The results lead to the conclusion that in healthy persons the artificial pressure rise influences the ganglion cells at an earlier timepoint than the signal transmission in the axons.
视觉诱发电位(VECP)会因眼内压(IOP)的人为升高而发生改变。损伤的确切位置仍不清楚。一种可能性是眼压升高会减少视神经乳头的血流量。这种效应会使视神经纤维功能下降。另一种可能性是人工升高的压力会影响视网膜神经节细胞中信号的产生。我们开发了一种在人为升高眼压期间同时记录图形翻转视网膜电图(PERG)和VECP的方法。PERG通过置于眼睑边缘附近的皮肤电极(美国格拉斯公司;直径5毫米)进行记录。图形翻转频率为7.9次/秒。在一项初步研究中,我们检查了10名眼压人为升高的健康志愿者。在9例中,VECP中振幅的行为比PERG中更稳定:6名志愿者的VECP中振幅/压力曲线的数学行为更稳定,PERG中出现过一次。在7名志愿者的VECP中发现了非常充分的自动调节迹象,PERG中出现过一次。当眼压进一步升高导致振幅持续下降至噪声水平时的临界压力,VECP(中位数53 mmHg)比PERG(中位数48 mmHg)稳定9倍。结果得出结论,在健康人中,人为升高的压力比轴突中的信号传递更早地影响神经节细胞。