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C. Perez Rico, P. de la Villa, R. Blanco; Multifocal Erg and Light-Induced Melatonin Suppression Evaluation of the Functional Integrity of the Retinohypothalamic Tract in Advanced Glaucoma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5490.
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To investigate the survival of melanopsin-expressing retinal ganglion cells (mRGCs) and the functional integrity of the retinohypothalamic tract in patients with bilateral advanced glaucomatous optic neuropathy by measuring the neuroendocrine light response of the pineal gland.
Nine patients with bilateral advanced primary open-angle glaucoma (glaucoma group) and nine normal control subjects (control group) were included in this pilot observational, prospective, case-control study. Best-corrected visual acuity logMAR, standard automated perimetry, optical coherence tomography measurements and multifocal electrorretinograpy recordings were evaluated. Melatonin was analyzed in the saliva by radioimmunoassay before and after exposure to bright light (600 lux) for 60 min at night.
The advanced glaucoma group did not have any significant nocturnal melatonin suppression after exposure to bright light (11.25 ± 5.68 pg/ml) (p>0.798) unlike the marked melatonin suppression in the control group (15.22 ± 10.68 pg/ml) (p< 0.05). Photoreceptor outer segments thickness were similar in both groups according to the optical coherence tomography Response density estimates by the scalar product amplitude measure for the interval 0 to 80 msec of the first-order kernel responses were similar in both groups, indicating that outer retinal function was significantly unchanged in the glaucoma group (5.95 ± 5.74 nV/dg^2) compared with the control group (6.20 ± 2.22 nV/dg^2) (p>0.689).
Our findings showed that human melanopsin-expressing retinal ganglion cells (mRGC) function was affected in advanced end-stage glaucoma, suggesting that attention should be paid to non-image-forming visual functions and its clinical impact in patients with advanced glaucoma.
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