scholarly journals Electrophysiological markers of advanced stages of glaucomatous optic neuropathy

2021 ◽  
Vol 14 (3) ◽  
pp. 19-24
Author(s):  
V. I. Kotelin ◽  
M. V. Zueva ◽  
I. V. Tsapenko ◽  
S. Yu. Petrov ◽  
A. N. Zhuravleva
Keyword(s):  
Steady State ◽  
Optic Neuropathy ◽  
Angular Size ◽  
Photopic Negative Response ◽  
Adaptive Plasticity ◽  
Control Group ◽  
Glaucomatous Optic Neuropathy ◽  
Pattern Erg ◽  
Advanced Stages ◽  
Transient And Steady State

Purpose: to determine the changes in electrophysiological parameters reflecting specific dysfunctions of retinal ganglion cells (RGCs) at advanced stages of glaucomatous optic neuropathy (GON).Material and methods. The study involved 35 patients (55 eyes) aged 51–76 (63.1 ± 7.7 years) with primary open-angle glaucoma (POAG), divided into two subgroups depending on POAG stages: developed (24 patients, 27 eyes) and advanced stages (24 patients, 28 eyes). The age-matched control group (aged 51–72, 59.8 ± 5.9) included 28 relatively healthy individuals (32 eyes). Transient and steady-state pattern ERG (PERG) and photopic negative response (PhNR) were recorded according to ISCEV standards.Results. A decrease in the amplitude of the transient PERG's N95 and P50-waves and steady-state PERG was found, the degree of which showed an inverse dependence on the angular size of the stimulus, which clearly distinguished the developed and advanced POAG stages from the initial GON. The developed stages are characterized by a decrease in the PhNR amplitude, calculated from the baseline, and the PhNR/b index, the reduction of which was the more significant the greater the intensity of the flash. A significant delay of the N95 peak for patterns of all angular sizes and a less pronounced lengthening of the latency of the P50 wave (significant only for small stimuli 0.8° and 0.3°) in comparison with the age norm were found. The latencies of the steady-state PERG and PhNR practically did not differ from the age norm values.Conclusion. The revealed reduction in the amplitudes of N95 and P50 waves of transient and steady-state PERG, PhNR, and the PhNR/b index, as well as an increase in the peak latency of N95 and P50 waves of transient PERG, may be markers of functional changes in the retina associated with non-adaptive plasticity or reflecting a combination of the processes of adaptive plasticity and degeneration of RGCs. Further research in this area will help give a more accurate characterization of the found regularities and apply the obtained results in clinical practice.

scholarly journals The photopic negative response (PhNR): measurement approaches and utility in glaucoma

2020 ◽  
Vol 40 (12) ◽  
pp. 3565-3576
Author(s):  
Matteo Prencipe ◽  
Tommaso Perossini ◽  
Giampaolo Brancoli ◽  
Mario Perossini
Keyword(s):  
Optic Neuropathy ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Diagnostic Process ◽  
Glaucomatous Optic Neuropathy ◽  
Specific Information ◽  
Automated Perimetry ◽  
Pattern Erg ◽  
Glaucomatous Damage ◽  
Additional Tool

Abstract Purpose Visual electrophysiological testing continues to generate interest among glaucoma experts because of its potential help in clarifying disease pathophysiology and promoting early detection of glaucomatous damage. The photopic negative response (PhNR) is a slow negative component of the full-field electroretinogram that has been shown to provide specific information about retinal ganglion cells (RGCs) activity. The purpose of this article is to review the literature to explore the currently available measurement methods and the utility of PhNR in glaucoma diagnostic process. Methods We gathered publications related to the origins, types of stimuli used, measurements methods and applications of the PhNR of ERG in animal models and humans through a search of the literature cited in PubMed. Search terms were: “PhNR”, “photopic negative response”, “glaucoma”, “glaucomatous optic neuropathy”, “ERG”, “electroretinogram”. Results The most reliable PhNR measurements are obtained using a red stimulus on a blue background, without requiring refractive correction, fixation monitoring, or ocular media transparency. Given its direct correlation with RGCs response, the PhNR measured as baseline-to-trough (BT) represents the most reliable parameter of evaluation. Glaucoma patients with evident perimetric defects show pathologic PhNR values. Even though the PhNR is promising in detecting early RGCs impairment, distinguishing between healthy subjects and suspect patients at risk of developing glaucomatous damage still remains challenging. Conclusion The PhNR is a useful additional tool to explore disorders that affect the innermost retina, including glaucoma and other forms of optic neuropathy. In particular, comparing reports of the standard examinations (optic disc assessment, OCT RNFL measurement, standard automated perimetry) with the results of electrophysiological tests may be helpful in solving clinical diagnostic and management dilemmas. On the one hand, the PhNR of the ERG can examine the parvocellular pathways; on the other hand, the steady-state pattern ERG optimized for glaucoma screening (PERGLA) can explore the magnocellular pathways. This could give ophthalmologists a useful feedback to identify early RGCs alterations suggestive of glaucoma, stratify the risk and potentially monitor disease progression.

scholarly journals Electrophysiological markers of preclinical diagnosis of glaucomatous optic neuropathy

2021 ◽  
Vol 14 (1) ◽  
pp. 35-41
Author(s):  
M. O. Kirillova ◽  
M. V. Zueva ◽  
I. V. Tsapenko ◽  
A. N. Zhuravleva
Keyword(s):  
Optic Neuropathy ◽  
Ganglion Cells ◽  
Open Angle Glaucoma ◽  
Statistical Significance ◽  
Photopic Negative Response ◽  
Glaucomatous Optic Neuropathy ◽  
Functional Changes ◽  
Bright Flash ◽  
Pattern Size ◽  
Group 2

Purpose: to evaluate the changes in electrophysiological indicators reflecting various aspects of the function of retinal ganglion cells (RGC) and their axons in the early diagnosis of glaucomatous optic neuropathy (GON).Material and methods. Two clinical groups, (1) 35 patients (60 eyes) aged 49 to 70 with suspected glaucoma and (2) 16 patients (30 eyes) aged 43–68 with initial primary open-angle glaucoma (POAG), and a comparison group of 38 relatively healthy subjects (45 eyes) aged 42–70 were tested for pattern-reversed visual evoked potentials (PVEP), transient and stationary pattern-ERGs (PERG) according to ISCEV, and photopic negative response (PhNR).Results. The P100 amplitudes in both clinical groups differed significantly from the norm in PVEP on small and large patterns. The elongation of peak latency (T) of P100 compared with norm was significant for the stimulus 1° in group 2. In both groups of patients, increased variability of the temporal parameters of PERG and PVEP for small patterns was found. In groups 1 and 2, a decrease in the amplitude of P50 and N95 peaks of transient PERG for all stimuli was revealed, which was the most significant for the 0.3° pattern. In group 1, the N95 peak was significantly delayed in PERG for large patterns. A statistically significant reduction in the steady-state PERG's amplitude was found in the groups of suspected glaucoma and initial POAG. The sharpest changes were found for small (0.8° and 0.3°) patterns. The elongation of T compared to the norm was most pronounced for PERG at 0.3°, but due to the high variability of temporary indicators within the group, it had no statistical significance. The amplitude of PhNR was significantly different from the norm in the ERG for a flash of 3.0 cd·sec/m2.Conclusion. In patients with suspected glaucoma, a decrease in the P100 VEP amplitude with the simultaneous elongation of T may be considered as a criteria for the plastic stage at the level of lateral geniculate nucleus. Markers of functional changes in RGCs are the decrease in the amplitude of PhNR in response to bright flash, and P50 and N95 of PERG for pattern size 0.3°. The results indicate a greater vulnerability of the parvocellular system to early events in the development of GON.

The Photopic Negative Response evaluation in patients with Leber's hereditary optic neuropathy

2021 ◽  
pp. 216-219
Author(s):  
M.S. Shmelkova ◽  
◽  
N.L. Sheremet ◽  
I.A. Ronzina ◽  
N.A. Andreeva ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Ganglion Cells ◽  
Optic Neuropathy ◽  
Ganglion Cells ◽  
Negative Response ◽  
Photopic Negative Response ◽  
Control Group ◽  
Retinal Ganglion ◽  
Leber's Hereditary Optic Neuropathy ◽  
Hereditary Optic Neuropathy

Purpose. To assess the retinal ganglion cells function in patients with Leber's hereditary optic neuropathy (LHON) by registering the photopic negative response (PhNR) while the photopic electroretinography is performed. Material and methods. 14 patients with different LHON mutations and 9 healthy individuals were examined. A standard ophtalmological examination was performed, including visual fields, spectral optical coherence tomography, photopic electroretinography and PhNR tests. Results. Significant differences in the PhNR latency (68.4±4.01/64.28±5.37, p<0,01) and the PhNR amplitude (21.5±9.34/32.72±12.73, p<0,003) were revealed in patients with LHON and the control group. The study revealed significant differences between the PhNR latency (р<0.01) and the PhNR amplitude (р<0.008) in patients with visual acuity (VA) ≤ 0.1 and the control group, and between the PhNR amplitude in patients with VA≥0.13 and the control group (р<0.05). There were found significant correlations between the PhNR parameters and visual acuity, mean sensitivity, RNFL and GCC thickness. A strong positive correlation was found between the PhNR amplitude and the GCC thickness in patients with VA≥0.3. Conclusion. The PhNR parameters reflect the retinal ganglion cells function in patients with LHON and correlate with RNFL and GCC structural changes. Key words: Leber hereditary optic neuropathy, mitochondrial optical neuropathies, retinal ganglion cell, photopic negative response, PhNR.

scholarly journals Mesenchymal stem cell surgery, rescue, and regeneration in glaucomatous optic neuropathy

2021 ◽  
Author(s):  
Paolo Giuseppe Limoli ◽  
Celeste Limoli ◽  
Enzo Maria Vingolo ◽  
Federica Franzone ◽  
Marcella Nebbioso
Keyword(s):  
Optic Neuropathy ◽  
Progressive Disease ◽  
Treated Group ◽  
Control Group ◽  
Glaucomatous Optic Neuropathy ◽  
Corrected Visual Acuity ◽  
Restoration Technique ◽  
The Mean ◽  
Cell Surgery ◽  
Sd Oct

Abstract Background Glaucomatous optic neuropathy (GON) is an anatomofunctional impairment of the optic nerve triggered by glaucoma. Recently, growth factors (GF) have been shown to produce retinal neuroenhancement. The suprachoroidal autograft of mesenchymal stem cells (MSC) by Limoli Retinal Restoration Technique (LRRT) has proven to achieve retinal neuroenhancement by producing GF directly into the choroidal space. This retrospectively registered clinical study investigated the visual function changes in patients with GON treated with LRRT. Methods: Twenty-five patients (35 eyes) with GON in progressive disease conditions were included in the study. Each patient underwent a comprehensive ocular examination, including analysis of Best Corrected Visual Acuity (BCVA) for far and near visus, sensitivity by Maia microperimetry, and the study of the spectral domain-optical coherence tomography (SD-OCT). The patients were divided into two groups: a control group, consisting of 21 eyes (average age 72.2 years, range 50–83) and an LRRT group, consisting of 14 eyes (average age 67.4, range 50–84). Results: After 6 months the BCVA, close-up visus, and microperimetric sensitivity significantly improved in the LRRT-treated group (p < 0.05), whereas the mean increases were not statistically significant in controls (p > 0.5). Conclusions: Patients with GON treated with LRRT showed a significant increase of visual performance (VP) both in BCVA and sensitivity and an improvement of residual close-up visus, in the comparison between the LRRT results and the control group. Further studies will be needed to establish the actual significance of the reported findings.

scholarly journals Analysis of central retinal microcirculation in glaucoma after neuroretinoprotective treatment

2021 ◽  
Vol 21 (1) ◽  
pp. 3-8
Author(s):  
N.G. Glazko ◽  
◽  
А.Е. Egorov ◽  
◽  
Keyword(s):  
Visual Field ◽  
Optic Neuropathy ◽  
Foveal Avascular Zone ◽  
Functional Improvement ◽  
Control Group ◽  
Mean Deviation ◽  
Glaucomatous Optic Neuropathy ◽  
Study Group ◽  
Treatment Type ◽  
Retinal Microcirculation

fractions of polypeptides (Retinalamin) were performed in the study group. Conventional treatment for glaucomatous optic neuropathy (antioxidants, vasodilators, nootropic drugs, and retinoprotectors) was performed in the control group. Results: in the study group, FAZ area reduced by 33% immediately after the treatment, by 28.7% after 1 month, and by 16.8% after 6 months compared to baseline. In addition, FAZ perimeter reduced by 26.7%, 17.6%, and 8.1%, respectively, compared to baseline. No significant changes in visual acuity, visual field indices, and FAZ parameters were revealed. Moderate and strong correlation between the mean deviation (MD) and FAZ area was revealed in both groups irrespective of treatment type (rstudy=-0.6044, р<0.05; rcontrol=-0.8249, р<0.05). Conclusion: OCTA assesses central retinal microcirculation by FAZ parameters. The changes in FAZ parameters illustrate treatment efficacy and correlate with functional improvement (as demonstrated by visual field testing). Hence, it is recommended to monitor FAZ parameters when providing neuroretinoprotective therapy to evaluate its effectiveness. Keywords: optical coherence tomography angiography, primary open-angle glaucoma, glaucomatous optic neuropathy, neuroretinoprotection, modified trophic laser photocoagulation, foveal avascular zone. For citation: Glazko N.G., Egorov А.Е. Analysis of central retinal microcirculation in glaucoma after neuroretinoprotective treatment. Russian Journal of Clinical Ophthalmology. 2021;21(1):3–8. DOI: 10.32364/2311-7729-2021-21-1-3-8.

scholarly journals Structural and Functional Correlations in Patients with Advanced Stages of Primary Open-Angle Glaucoma

2021 ◽  
Vol 18 (2) ◽  
pp. 266-275
Author(s):  
V. I. Kotelin ◽  
S. Yu. Petrov ◽  
A. N. Zhuravleva ◽  
M. V. Zueva ◽  
I. V. Tsapenko
Keyword(s):  
Ganglion Cell ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Photopic Negative Response ◽  
Inner Plexiform Layer ◽  
Pattern Erg ◽  
Open Angle ◽  
Functional Relationships ◽  
Rnfl Thickness ◽  
Advanced Stages

Purpose: To study the correlations in the diagnosis of patients with advanced stages of primary open-angle glaucoma (POAG) using data from electroretinography and optical coherence tomography (OCT) of the retina.Methods. The study was performed in two clinical subgroups of patients (35 people, 55 eyes) with stages II and III POAG and the age-matched control group (28 healthy people, 32 eyes). The thickness of the ganglion cell complex (GCC), including the retinal nerve fiber layer (RNFL), the retinal ganglion cell layer (RGC), and the inner plexiform layer (INL) in the macular region, was assessed in nine segments. Correlation analysis of morphometric parameters of GCC in advanced POAG was performed with data from previously performed electroretinography: the transient pattern-ERG (T-PERG), stationary pattern-ERG (S-PERG), and photopic negative response (PhNR).Results. Statistically significant (p < 0.01) thinning of all layers of the GCC was revealed in all studied sectors. Significant (p < 0.05) differences in all morphometric characteristics were recorded between the two subgroups. In patients of the 1st subgroup, the greatest differences in morphological parameters from the control group’s values were noted in the lower, upper parafoveal sectors of the RGC layer, as well as in the temporal perifoveolar quadrant. In the 2nd subgroup, significant changes in the thickness of the inner retina layers were recorded for the upper and lower peripheral sectors of the RNFL and the temporal para- and peripheral quadrants of the RGC layer. In the study of morphological-functional relationships, the most significant correlations were revealed for the parameters of S-PERG. The amplitude of S-PERG directly correlated with the thickness of RNFL in the nasal sector of the perifovea (r = 0.86; p < 0.01) in the 1st subgroup of patients and the thickness of the RGC in the nasal sector of the perifovea in the 2nd subgroup (r = 0.84; p < 0.01). Moderate relationships were revealed between the N95/P50 T-PERG index and the RNFL thickness in the upper sector of the perifovea (r = 0.46; p < 0.05), the peak N95 T-PERG latency, and the RNFL thickness in the upper sector of the perifovea (r = –0.43; p < 0.05) in patients of the 1st subgroup. In patients of the 2nd subgroup, there was a correlation between the amplitude of N95 T-PERG and the thickness of the RGC in the lower sector of the perifovea (r = –0.42; p < 0.01), the peak latency of N95, and the thickness of the RNFL in the upper sector of the parafovea (r = –0.31; p < 0.05). A direct correlation was established between the PhNR amplitude from the baseline and the thickness of the RGC layer in the perifovea’s temporal sector (r = 0.72; p < 0.01) in patients with stage II POAG. The PhNR amplitude from the b-wave peak in patients with stage III POAG correlated with the RNFL thickness in the perifovea’s nasal sector (r = 0.51; p < 0.01).Conclusion. Specific patterns of morphological-functional changes in the parameters of the retina’s inner layers in patients with advanced POAG are presented, which can be used as clinical markers in determining an individual therapeutic strategy. 

THE LEVEL OF CYTOKINES IN THE SALIVA OF PATIENTS WITH BREAST CANCER

2019 ◽  
Vol 65 (6) ◽  
pp. 825-831
Author(s):  
Lyudmila Belskaya ◽  
Viktor Kosenok
Keyword(s):  
Breast Cancer ◽  
Control Group ◽  
Early Stages ◽  
Promising Tool ◽  
Urgent Task ◽  
Advanced Stages ◽  
New Biomarkers ◽  
Histological Verification ◽  
Control Study ◽  
Biochemical Examination

Currently, the urgent task is to search for new biomarkers as a promising tool for early detection and monitoring of breast cancer. The aim of the study was to study the level of cytokines in the saliva of patients with breast cancer. In the case-control study volunteers participated, which were divided into 3 groups: the main (breast cancer, n = 43), the comparison group (fibroadenoma, n = 32) and the control group (conditionally healthy, n = 39). All participants were questioned; biochemical examination of saliva, histological verification of the diagnosis was carried out. Intergroup differences are estimated by a nonparametric criterion. It is shown that in the context of breast cancer, the level of cytokines (IL-2, IL-4, IL-6, IL-10 and IL-18) is increasing, except for IL-8, the content of which decreases compared to the control group. When the disease progresses by the nature of the dynamics, the parameters are divided into two groups: IL-2, IL-4, IL-18 and IL-6, IL-8, IL-10. For the first group of cytokines, there was a decrease in content during the transition from the early stages to the more common ones. For the second group, when passing from stages T1-2N0M0 to T1-2NjM0, the level of cytokines remains practically constant. In the future, the level of cytokines is observed for stage T3_4N0_2M0, and for IL-2, IL-4 and IL-10, the level of cytokines reaches values corresponding to early stages, whereas for IL-6, IL-8 and IL-18 in the same direction, a significant increase in indicators was noted. Additionally, the IL-6/IL-8 ratio was calculated depending on the tumor size, as well as the presence / absence of metastasis. It is shown that this ratio is statistically significantly increased in the advanced stages of the disease. Particularly interesting is the increase in this ratio in saliva at the initial stages of the disease.

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