Posterior Pole Asymmetry Analysis as a Diagnostic Tool in Glaucoma Suspects: An Electrophysiological Approach.

IF 1.8 Q3 OPHTHALMOLOGY
Clinical ophthalmology Pub Date : 2023-06-21 eCollection Date: 2023-01-01 DOI:10.2147/OPTH.S411647
Andrew Tirsi, Paras P Shah, Vasiliki Gliagias, Daniel Barmas-Alamdari, Derek Orshan, Joby Tsai, Celso Tello
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引用次数: 0

Abstract

Purpose: Spectral domain optical coherence tomography (SD-OCT) with posterior pole asymmetry analysis (PPAA) provides a mapping of posterior pole retinal thickness with asymmetry analysis between hemispheres of each eye. We investigated whether these structural abnormalities were correlated with functional retinal ganglion cell (RGC) loss, quantified by steady state pattern electroretinogram (ssPERG), in glaucoma suspects (GS).

Methods: Twenty GS (34 eyes) were enrolled in a prospective study at the Manhattan Eye, Ear, and Throat Hospital. All subjects underwent ophthalmological examination, including Humphrey visual field, Spectralis Glaucoma Module Premium Edition (GMPE) SD-OCT PPAA, and ssPERG testing. The ability of ssPERG parameters (Magnitude [Mag, µv], MagnitudeD [MagD, µv], and MagD/Mag ratio) to predict PPAA thickness (total, superior, and inferior thickness, [µm]) was tested via adjusted multivariate linear regression analysis.

Results: Mag explained 8% of variance in total PPAA change (F(1,29)=6.33, B=6.86, 95% CI: 1.29-12.44, p=0.018), 8% in superior PPAA change (F(1,29)=5.57, B=6.92, 95% CI: 0.92-12.92, p=0.025), and 7.1% in inferior PPAA change (F(1,29)=5.83, B=6.80, 95% CI: 1.04-12.56, p=0.022). Similarly, MagD explained 9.7% of variance in total PPAA change (F(1,29)=8.09, B=6.47, 95% CI: 1.82-11.13, p=0.008), 10% in superior PPAA change (F(1,29)=7.33, B=6.63, 95% CI: 1.62-11.63, p=0.011), and 8.5% in inferior PPAA change (F(1,29)=7.25, B=6.36, 95% CI: 1.53-11.18, p=0.012). MagD/Mag ratio and PPAA were not significantly associated.

Conclusion: To the best of our knowledge, this is the first study demonstrating a positive relationship between RGC dysfunction and retinal thickness changes between the superior and inferior hemispheres. The detection of asymmetrical structural loss, combined with functional RGC assessment using ssPERG, may be an informative tool for early glaucoma diagnosis.

Abstract Image

Abstract Image

作为青光眼疑似患者诊断工具的后极不对称分析:电生理学方法。
目的:带后极不对称分析(PPAA)的光谱域光学相干断层扫描(SD-OCT)可绘制后极视网膜厚度图,并对每只眼睛的半球进行不对称分析。我们研究了这些结构异常是否与青光眼疑似患者(GS)的功能性视网膜神经节细胞(RGC)缺失相关(通过稳态模式视网膜电图(ssPERG)量化):曼哈顿眼耳鼻喉科医院的一项前瞻性研究招募了 20 名青光眼疑似患者(34 只眼)。所有受试者均接受了眼科检查,包括汉弗莱视野、Spectralis Glaucoma Module Premium Edition (GMPE) SD-OCT PPAA 和 ssPERG 测试。通过调整后的多元线性回归分析,测试了ssPERG参数(Magnitude [Mag,µv]、MagnitudeD [MagD,µv]和MagD/Mag比值)预测PPAA厚度(总厚度、上部厚度和下部厚度,[µm])的能力:Mag解释了PPAA总厚度变化8%的方差(F(1,29)=6.33, B=6.86, 95% CI: 1.29-12.44, p=0.018),解释了PPAA上厚度变化8%的方差(F(1,29)=5.57,B=6.92,95% CI:0.92-12.92,p=0.025),下部 PPAA 变化为 7.1%(F(1,29)=5.83,B=6.80,95% CI:1.04-12.56,p=0.022)。同样,MagD 可解释 9.7% 的 PPAA 总变化方差(F(1,29)=8.09, B=6.47, 95% CI: 1.82-11.13, p=0.008),10% 的 PPAA 上位变化方差(F(1,29)=7.33,B=6.63,95% CI:1.62-11.63,p=0.011),下部 PPAA 变化为 8.5%(F(1,29)=7.25,B=6.36,95% CI:1.53-11.18,p=0.012)。MagD/Mag比值与PPAA无明显相关性:据我们所知,这是首次有研究表明 RGC 功能障碍与上下半球视网膜厚度变化之间存在正相关关系。利用ssPERG检测非对称结构性损失并结合功能性RGC评估,可能是早期青光眼诊断的一种信息工具。
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来源期刊
Clinical ophthalmology
Clinical ophthalmology OPHTHALMOLOGY-
CiteScore
3.50
自引率
9.10%
发文量
499
审稿时长
16 weeks
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