图形视网膜电图和视觉诱发电位对检测高眼压和青光眼视功能损害的临床能力

来源 :世界核心医学期刊文摘.眼科学分册 | 被引量 : 0次 | 上传用户:kr1983
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Objective: To assess the presence of normal or abnormal pattern electroretinogram (PERG) and visual evoked potential (VEP)-responses in patients with ocular hypertension or open-angle glaucoma (OAG). Design: Retrospective,cross-sectional,case-control study. Participants: Eighty normal control subjects (mean age,51.77± 6.04 years; 80 eyes),68 ocular hypertension patients (mean age,51.58± 7.12; 68 eyes; intraocular pressure IOP < 18 mmHg under pharmacological treatment; Humphrey field analysis HFA 24/2 mean deviation MD >-2 decibels dB),and 84 OAG patients (mean age,52.77± 5.28; 84 eyes; IOP < 18 mmHg under pharmacological treatment; HFA24/2mean deviation between-2 and-23 dB)were enrolled. Methods: Simultaneous recording of PERGs and VEPs using high-contrast (80% ) 15 checkerboard stimuli reversed at the rate of 2 reversals per second. Main Outcome Measures: Pattern electroretinogram P50 and VEP P100 implicit times were considered delayed when exceeding the limit of mean values of controls plus 2 standard deviations (SDs). Pattern electroretinogram P50 to N95 and VEP N75 to P100 amplitudes were considered reduced when exceeding the limit of mean values of controls minus 2 SDs. Results: Pattern electroretinogram: P50 implicit times were delayed in 58 of 68 (85.30% ) ocular hypertension eyes and 83 of 84 (98.80% )OAG eyes; P50 toN95 amplitudes were reduced in 47 (69.12% ) ocular hypertension eyes and 84 (100% ) OAG eyes. Visual evoked potential: P100 implicit times were delayed in 58 (85.30% ) ocular hypertension eyes and 84 (100% ) OAG eyes; reduced N75 to P100 amplitudes were observed in 39 (57.35% ) ocular hypertension eyes and 73 (86.90% ) OAG eyes. Ocular hypertension eyes showed no significant correlations (Pearson test,P>0.01) between electrophysiological parameters and age,IOP before or under medical treatment,HFA,and corneal thickness values. Significant correlations (P<0.01) were observed in OAG eyes between electrophysiological results and HFA values. Pattern electroretinogram and VEP responses were normal in all control eyes. Conclusions: Combined PERG/VEP recordings identified a large percentage of ocular hypertension eyes with impairment of the innermost retinal layers,not withstanding normal optic disc morphology and normal HFA. In OAG eyes,PERG P50 to N95 amplitude and VEP P100 implicit time showed the highest sensitivity/specificity for the detection of a visual dysfunction. The presence of abnormal PERG and/or VEP responses did not allow a clearcut separation between ocular hypertension and OAG eyes. Objective: To assess the presence of normal or abnormal pattern electroretinogram (PERG) and visual evoked potential (VEP) -responses in patients with ocular hypertension or open-angle glaucoma (OAG). Design: Retrospective, cross-sectional, case- . Participants: Eighty normal control subjects (mean age, 51.77 ± 6.04 years; 80 eyes), 68 ocular hypertensive patients (mean age, 51.58 ± 7.12; 68 eyes; intraocular pressure IOP <18 mmHg under pharmacological treatment; Humphrey field analysis HFA 24 / 2 mean deviation MD> -2 decibels dB), and 84 OAG patients (mean age 52.77 ± 5.28; 84 eyes; IOP <18 mmHg under pharmacological treatment; HFA24 / 2 deviation between -2 and -23 dB) were enrolled. Methods: Simultaneous recording of PERGs and VEPs using high-contrast (80%) 15 checkerboard stimu-re at the rate of 2 reversals per second. Main Outcome Measures: Pattern electroretinogram P50 and VEP P100 implicit times were considered delayed when exceeding the limit of mean values ​​of con Results: Pattern electroretinogram P50 to N95 and VEP N75 to P100 amplitudes were reduced reduced exceeding exceeding the limit of mean values ​​of controls minus 2 SDs. Results: Pattern electroretinogram: P50 implicit times were delayed in 58 of 68 P50 toN95 amplitudes were reduced in 47 (69.12%) ocular hypertension eyes and 84 (100%) OAG eyes. Visual evoked potential: P100 implicit times were delayed (85.30%) ocular hypertension eyes and 83 of 84 (98.80% Ocular hypertension eyes and 84 (100%) OAG eyes; reduced N75 to P100 amplitudes were observed in 39 (57.35%) ocular hypertension eyes and 73 (86.90%) OAG eyes. Ocular hypertension eyes showed no significant correlations Significant correlations (P <0.01) between electrophysiological parameters and age, IOP before or under medical treatment, HFA, and corneal thickness values. Significant correlations (P <0.01) were observed in OAG eyes between electrophysiological results and HFA values. ernElectroretinogram and VEP responses were normal in all control eyes. Conclusions: Combined PERG / VEP recordings identified a large percentage of ocular hypertensive eyes with impairment of the innermost retinal layers, not withstanding normal optic disc morphology and normal HFA. In OAG eyes, PERG P50 to N95 amplitude and VEP P100 implicit time showed the highest sensitivity / specificity for the detection of a visual dysfunction. The presence of abnormal PERG and / or VEP responses did not allow a clear cut separation between ocular hypertension and OAG eyes.
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