结论:功能性近红外光谱技术用于评估原发性开角型和原发性闭角型青光眼患者的视皮层活动。青光眼患者的视皮层活动减少,与青光眼的严重程度有关。
目的:使用fNIRS(功能性近红外光谱)评估原发性开角型青光眼(POAG)和原发性闭角型青光眼(PACG)与健康对照组的视皮层活性。
方法:总共30个POAG,31PACG,在这项有目的的横断面观察性试验研究中,从一个中心招募了30名健康的老年匹配对照.POAG和PACG组年龄匹配,但招募时疾病严重程度不匹配。所有参与者都使用多通道连续波近红外系统NIRSport8×7设备(NIRxMedizintechnikGmbH,柏林,德国)。根据10秒内氧合血红蛋白(OxyHb)浓度变化的最大幅度评估视觉皮层活性,并在三组之间进行比较。将POAG和PACG组合并(称为青光眼组)以评估视觉皮层活动与疾病严重程度的关系(通过视野缺损(平均偏差)和视网膜神经纤维层(RNFL)厚度)。
结果:所有参与者在刺激表现过程中表现出OxyHb升高和DeoxyHb降低的特征性反应。与对照组相比,POAG和PACG组的OxyHb浓度在10秒内的最大变化幅度显着降低(P<0.05)。PACG与POAG之间无显著差别。重要的是,青光眼组视觉皮层活动与视野缺损(平均偏差)呈负相关(P<0.05),与RNFL厚度呈正相关(P<0.05)。
结论:在青光眼患者中,观察到视觉皮层活动的减少,这可能表明枕叶皮层中发生了神经元变性。青光眼的疾病严重程度似乎与视觉皮层活动密切相关。fNIRS可以作为评估青光眼血流动力学和神经退行性变化的有用神经成像方式。
CONCLUSIONS: Functional near-infrared spectroscopy (fNIRS) was used to assess visual cortical activity in patients with primary open angle (POAG) and primary angle closure (PACG) glaucomas. There was decreased activity in the visual cortex of glaucoma patients correlating with the severity of glaucoma.
OBJECTIVE: To evaluate visual cortex activity using fNIRS in POAG and PACG compared with healthy controls.
METHODS: A total of 30 POAGs, 31 PACGs, and 30 healthy aged-matched controls from a single centre were recruited in this cross-sectional observational pilot
study with purposive sampling. The POAG and PACG groups were age-matched but were not matched for disease severity at recruitment. All participants underwent fNIRS testing using a multichannel continuous-wave near-infrared system NIRSport 8×7 device (NIRx Medizintechnik GmbH). The visual cortex activity was evaluated in terms of the maximum amplitude of change in oxyhemoglobin (OxyHb) concentration over 10 seconds, and a comparison was done among 3 groups. Both POAG and PACG groups were combined (termed as glaucoma group) to assess the relationship of visual cortical activity with disease severity (by visual field defect (mean deviation) and retinal nerve fibre layer thickness).
RESULTS: All participants showed the characteristic response of increased OxyHb and decreased deoxyhemoglobin during stimulus presentation. The maximum amplitude of change in OxyHb concentration over 10 seconds was significantly lower in both POAG and PACG groups compared with control in the right and left middle occipital gyri ( P < 0.05). There was no significant difference between PACG and POAG. Importantly, there was a negative correlation between the visual cortex activity with the visual field defects (mean deviation; P < 0.05) and a positive correlation with retinal nerve fibre layer thickness in the glaucoma group ( P < 0.05).
CONCLUSIONS: In patients with glaucoma, a reduction in visual cortical activity was observed, which may be indicative of neuronal degeneration occurring in the occipital cortex. Disease severity in glaucoma appears to be closely correlated with visual cortex activity. fNIRS can serve as a useful neuroimaging modality for assessing the hemodynamic and neurodegenerative changes in glaucoma.