Purpose. To determine the relationship among photopic negative response (PhNR) of the electroretinogram (ERG), retinal nerve fiber layer (RNFL) thickness, and the visual field in normal and glaucomatous patients. Methods. Thirty-eight normal volunteers and one hundred twenty-four patients with Primary open-angle glaucoma (POAG) were enrolled in the study. The PhNRs were elicited by white stimuli on a white background and red stimuli on a blue background. The visual field parameters were measured using the standard automated perimetry (SAP). The spectral domain optical coherence tomography (SD-OCT) was used to measure the retinal nerve fiber layer (RNFL) thickness around the optic disc. Results. The PhNR amplitude (W/W, B/R), MD, and mean RNFL thickness in POAG eyes were significantly lower than normal eyes (P = 0.001). The R value in Normal + Glaucomatous group was higher than that of the only glaucomatous group. The R values of PhNR amplitude (B/R) with MD and RNFL were higher than those of PhNR amplitude (W/W). Significant linear association was found in the relationship between RNFL thickness and PhNR amplitude (B/R) (R 2 = 0.5, P = 0.001). However, significant curve associations were found in the relationship between MD and PhNR amplitude (B/R) and RNFL thickness (R 2 = 0.525, 0.442, P = 0.001). Conclusions. The ganglion cell activity can be more efficiently evaluated with the PhNR elicited with a red than with a broadband stimulus. The linear relationship between the PhNR amplitude and RNFL thickness indicates that inner retinal function declines proportionately with neural loss in glaucomatous eyes. The PhNR and RNFLT are more objective tools to detect glaucomatous damage than visual field.

Ultrasound microbubble combined optic protection drugs have obvious protective effect on optic nerve damage. This way of targeting drug delivery is becoming more simple, not through the whole body metabolism, avoiding drug via blood circulation when facing the decomposition and the environment in the interference and destruction process of drugs, to maximize the guarantee to reach target organs of drug concentration and to reache the maximum therapeutic effect. The technique of ultrasound microbubbles is safe, controllable, nonimmunogenic, and repeatable. It provides us with a novel idea in the administration of neuroprotective drugs.

Background: To investigate the protective effect of ultrasound microbubble combined with gross saponins of tribulus terrestris (GSTT) (a Chinese herb) on glaucomatous optic nerve damage.Methods: Rabbits were randomly divided into five groups. Normal (Group A), high intraocular pressure (IOP, Group B), GSTT (Group C), GSTT + ultrasound (Group D), and GSTT + ultrasound + microbubble destruction (Group E). The high intraocular pressure eye (model eye) was compared to the normal eye (control eye) at 1, 2, and 4 weeks after model establishment. Rabbits were sacrificed 4 weeks later to measure the retina thickness using Cirrus OCT, slit lamp photograph, and fundus photography. The retina and optic nerve of rabbits in each group were collected and the stretched retina were prepared for retinal ganglion cell (RGC) counting, the optic nerve axon was measured, and a transmission electron microscopy was used.Results: Retina thickness based on Cirrus OCT: mean retinal thickness in Group E was significantly greater than that in Group B, but still thinner than that in Group A. RGCs counts: RGCs counts in Group E were significantly higher than those in Groups B, C, and D but still lower than those in Group A.Quantitative analysis of optic nerve axons: In Group E, the number of optic nerves was increased, diameters of optic nerve axons were decreased, the percentage of optic nerve area occupied by axons was increased, and there were statistically significant differences compared to Groups B, C, and D. Content of GSTT in retina:The content of GSTT in Group E was significantly higher than that in other groups. Observation of the rabbit optic nerves: In Group E, the structure of the myelin sheath of the optic nerve was still intact but less ordered, and the microtubule and microfilament structures in the axons were clear.Conclusions: Combination of the ultrasound microbubble and GSTT can improve the protective effect of GSTT on optic nerve damage in rabbits with ocular hypertension.