| Objective:Glaucoma is a group of diseases with characteristic optic atrophy and visual field defect,Primary Open Angle Glaucoma is a kind of glaucoma,the angle of the anterior chamber angle is open,the symptom is concealed,and often progresses to middle and late stage when discovered.Visual field is the gold standard to diagnose and evaluate the progression of glaucoma,and is the basis for the staging of primary open angle glaucoma.However,the results of visual field examination are often limited by subjective factors and need to be learned by the examiner.In recent years,electrophysiological examination has been widely used in clinical,multifocal electroretinogram electrophysiological examination is an objective examination,which can make up for the lack of visual field subjective examination.Studies have shown that a complete ganglion cell axon is needed to produce a normal Mferg response,suggesting that in the early stages of glaucoma,if ganglion cells are abnormal,Mferg have ample opportunity to detect damage to the optic ganglion,early glaucoma can be detected earlier and more accurately,directing clinical treatment and controlling the course of the disease.In this study,we attempted to investigate the correlation between mean defectvalue,standard deviation mode value and the amplitude density of Mferg P wave and MD in the early,middle and late stage of POAG.to explore the clinical significance of Mferg parameters in detecting the progression of POAG.Methods: From February 2017 to October 2017,60 patients(84 eyes)of ophthalmic POAG in Hospital were selected,of each stage group 20 patients 28 eyes were included in the early POAG,28 in the healthy volunteers and 16 in the control group.According to the conditions of the general examination of ophthalmology,such as eyesight,correction of vision,intraocular pressure,anterior chamber angle,fundus,and other examinations,those patients included in each group received ophthalmic examination : Mferg,Humphrey Visual field,coherent optical tomography OCT(optic disc and macular),with SPSS 24 software for data processing,The data samples of POAG group and normal control group were measured by means of the mean ±standard deviation(x±s),using the Independent sample T test to compare the early,middle and late Poag group and the normal control group,the statistical significance(p<0.05)was selected to evaluate the diagnostic value of each parameter,and the ROC curve was drawn earlier,middle and In the late Roc curve area difference,using the linear trend analysis to analyze the early,middle and late Mferg value change tendency,Pearson the correlation analysis method to discuss the R1-R5 ring and the MD value correlation.Results: 1.General Data analysis: There was no statistically significant difference between age and diopter between the early,middle and late POAG three groups and the normal control group(p>0.05)(after the conversion equivalent ball lens).2.mfERG parameter Analysis:2.1 The amplitude density of r1-r5 ring in early,middle and late POAG group was lower than that in normal control group,the difference of early group 1-5 ring was statistically significant(p<0.05),POAG Medium Group except 4 ring,the difference was statistically significant(p<0.001),and late group 1-5 ring difference was statistically significant(p< 0.001)2.2In the POAG group,the amplitude density of the P1 wave R1 ring was the largest,and the amplitude density of the r1-r3 ring was lower than that in the periphery.2.3 The latency time of P1 wave in R1-R5 ring of POAG Group was longer than that in the normal control group,the early group: 1-5 ring difference was not statistically significant(p>0.05),only 3,4 and 5 in the medium group were statistically significant(p<0.05).Only 1,4,5 rings were statistically significant in the late group(p<0.05)2.4The amplitude density of the P1 wave in the four quadrants of POAG was decreased compared with the normal control group,and there were statistically significant differences in the early and intermediate four quadrants(p<0.05),The difference of four quadrants in the late group was statistically significant(p<0.001),the latency of P1 wave in four quadrants of POAG group was longer than that in normal group,and the difference in early group was statistically significant(p<0.05),There were statistically significant differences in the lower temporal,nasal and nasal quadrants of the middle and late group(p<0.05),The rest of the quadrants had no significant difference compared to the normal control group(p>0.05).3.Mferg and MD Value correlation: POAG each group MD value and the PSD value compared with the normal control group have the difference significance(p<0.05),the MD value and the Mferg P1 wave R1-R5 ring data carries on the analysis,POAG each group MD value and the Mferg The amplitude density of R1-R5 ring P1 Wave is positively correlated(p<0.05).4.The amplitude density of P wave r1-r5 ring and the amplitude density of four quadrants were gradually decreasing in early,middle and late stage of POAG,and the descending trend was significant difference(p-trend<0.01).Conclusion:1.mfERG examination can reflect the damage of retina structure and function in patients with POAG,and it is valuable for POAG patients to guide clinical treatment2.The r1-r5 amplitude density of Mferg P1 waves in all groups of POAG was decreased,especially in 1 ring(macular region),and it was speculated that macular retinal nerve fiber layer was damaged in early glaucoma patients and was more serious than other regions.3.The mferg R1-R5 ring P1 wave amplitude density and the MD value of visual field average defect in POAG group were positively correlated(p<0.001),Mferg the progression of P1 by R1-R5 wave Poag ring amplitude density value.4The amplitude density of P wave r1-r5 ring and amplitude density of four quadrants were gradually decreasing in POAG early and middle and late group,and Mferg amplitude density was positively correlated with POAG patients. |
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