Early impairment of magnocellular visual pathways mediated by isolated-check visual evoked potentials in primary open-angle glaucoma: a cross-sectional study.

IF 2 Q2 OPHTHALMOLOGY BMJ Open Ophthalmology Pub Date : 2024-01-17 DOI:10.1136/bmjophth-2023-001463
Qiaona Ye, Kezheng Xu, Zidong Chen, Zitian Liu, Yanmei Fan, Pingping Liu, Minbin Yu, Yangfan Yang
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Abstract

Objective: To explore different performances in the magnocellular (MC) and parvocellular (PC) visual pathways in patients with primary open-angle glaucoma (POAG) and to objectively assess impairment in early stage of POAG.

Methods and analysis: This is a cross-sectional study. MC and PC visual pathways were assessed using isolated-check visual evoked potential (ic-VEP). Visual acuity, intraocular pressure, fundus examination, optical coherence tomography and visual field were measured. Signal-to-noise ratios (SNRs), mediated by ic-VEP were recorded. The Spearman's correlation analysis was used to estimate the relationships between visual functions and structures. Receiver-operating-characteristic (ROC) curves were used to estimate the accuracy in detection of early POAG.

Results: 60 participants (30 early POAG eyes and 30 age-matched control subjects) were recruited. MC visual pathway showed a non-linear response function, while PC visual pathway was a linear response function as contrast increased. Early POAG eyes exhibited significantly weaker initial contrast gains and lower maximum responses in the MC visual pathway (p=0.001, p=0.004, respectively). The SNRs at 8% and 32% depths of modulation (DOM) were significantly correlated with temporal-side retinal nerve fibre layer (RNFL) thickness in early POAG in MC-biased stimulation (p=0.017, p=0.020, respectively). The areas under ROC of 16% DOM were 0.780 (sensitivity 80.0%, specificity 63.3%) with the cut-off SNR of 2.07.

Conclusions: The MC visual pathway was damaged in the early stage of POAG. The SNRs at 8% and 32% DOM of MC-biased stimulation were significantly correlated with temporal-side RNFL thickness in early POAG, which helped in understanding the mechanisms of visual impairment in the early stage of POAG.

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原发性开角型青光眼孤立检查视觉诱发电位介导的巨细胞视觉通路早期损伤:一项横断面研究。
目的探讨原发性开角型青光眼(POAG)患者的大细胞(MC)和旁细胞(PC)视觉通路的不同表现,并客观评估 POAG 早期的损伤情况:这是一项横断面研究。方法和分析:这是一项横断面研究,使用隔离-检查视觉诱发电位(ic-VEP)评估 MC 和 PC 视觉通路。同时还测量了视力、眼压、眼底检查、光学相干断层扫描和视野。记录了由 ic-VEP 介导的信噪比(SNR)。斯皮尔曼相关分析用于估算视觉功能和结构之间的关系。使用接收方操作特征曲线(ROC)来估计检测早期 POAG 的准确性:共招募了 60 名参与者(30 名早期 POAG 患者和 30 名年龄匹配的对照组)。MC 视觉通路显示出非线性响应函数,而 PC 视觉通路随着对比度的增加显示出线性响应函数。早期 POAG 眼睛的 MC 视觉通路显示出明显较弱的初始对比度增益和较低的最大响应(分别为 p=0.001 和 p=0.004)。在 MC 偏向刺激下,早期 POAG 患者在 8%和 32% 调制深度 (DOM) 下的信噪比与颞侧视网膜神经纤维层 (RNFL) 厚度显著相关(分别为 p=0.017 和 p=0.020)。16%DOM的ROC下面积为0.780(灵敏度80.0%,特异性63.3%),临界信噪比为2.07:在 POAG 早期,MC 视觉通路就已受损。8%和32% DOM的MC偏向刺激信噪比与早期POAG患者颞侧RNFL厚度显著相关,这有助于了解POAG早期视力受损的机制。
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来源期刊
BMJ Open Ophthalmology
BMJ Open Ophthalmology OPHTHALMOLOGY-
CiteScore
3.40
自引率
4.20%
发文量
104
审稿时长
20 weeks
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