多种视觉电生理联合视野检查对原发性开角型青光眼早期诊断的敏感性  

Combined application of visual electroretinography and perimetry in the early primary open angle glaucoma

作　　者：石一宁[1] 常宝琴[1] 陈建华[1] 郭建强[1] 伊恩晖[1] 

机构地区：[1]西安市中心医院眼科,710003

出　　处：《眼科研究》2004年第4期424-427,共4页Chinese Ophthalmic Research

摘　　要：目的　探讨多种视觉电生理联合全自动视野计检查对原发性开角型青光眼早期诊断的敏感性 ,为临床早期诊断提供客观敏感的指标。方法　选择 10例 ( 2 0眼 )原发性开角型青光眼患者和正常对照者 10例 ( 2 0眼 )分别进行闪光视网膜电图 (F ERG)、图形视网膜电图 (P ERG)、图形视诱发电位 (P VEP)检查 ;还对正常对照组、青光眼组中各 5例 10眼进行多焦视网膜电图 (mERG)检查 ;青光眼组 10例 ( 2 0眼 )和正常对照组 8例 ( 16眼 )行蓝黄视野 (B/Y)、标准视野 (W /W )检查。结果　P ERG的N95潜伏期延长较敏感 ;P VEP的P10 0 波振幅降低 ,潜伏期延长但与对照组无明显差异 ;mERG二阶反应振幅下降 ,并随离心度的增大而明显降低 ;B/Y视野检查的视野异常阳性率显著高于W /W视野。结论　B/Y视野检查联合多种视功能检查对原发性开角型青光眼早期诊断较敏感。在眼底杯 /盘比未出现改变的早期诊断中 ,B/Y视野和PERG敏感性较高。ObjectiveTo evaluate the clinical value of different electroretinographies and automated perimetry in the diagnosis of early primary open angle glaucoma(POAG).MethodsTen normal individuals (20 eyes) and 10 patients(20 eyes) with early POAG were examined by flash electroretinography(F-ERG),pattern electroretinography(P-ERG) and pattern visual evoked potential(P-VEP).Five normal individuals and 5 patients(10 eyes) in the two groups were examined by the multifocal electroretinography(mERG).Eight normal individuals (16 eyes) and 10 patients(20 eyes) in the two groups were tested by blue-on-yellow (B/Y) and white-on-white (W/W) automated perimetries.The testing results between two groups were analyzed.ResultThe changes of P-ERG,P-VEP,mERG,B/Y and W/W were found in the early POAG group.The N 95 latency of P-ERG was (96.85±13.93)ms in POAG group and (89.83±11.31)ms in the control group.The P-VEP showed reduction of amplitude and prolong of latency of P 100 wave,but no significant difference compered to the control group.The amplitudes of secondary order response of mERG were significantly declined,especially at the 4th-6th rings.The abnormal visual field change was observed by B/Y pemeritry(mean sensitivity 20.23±4.04),showing more sensitive than W/W pemeritry(mean sensitivity 25.57±3.45).ConclusionB/Y visual field examination combined with different electroretinographies is more sensitive to the early diagnosis of POAG.B/Y perimetry and P-ERG are the optimal selections of the early cases without cup/disc ratio changes.

关 键 词：原发性开角型青光眼 视野 视觉电生理 诊断 

分 类 号：R775.204[医药卫生—眼科]