视网膜色素变性患者视锥和视杆细胞多焦视网膜电图检测  

Multifocal electroretinogram of rod and cone cells in patients with retinitis pigmentosa

作　　者：刘勇[1] 余延基[1] 阴正勤[1] 

机构地区：[1]第三军医大学西南眼科医院,重庆400038

出　　处：《中华眼底病杂志》2009年第6期433-436,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：重庆市自然科学基金重点资助课题（2006BA5002）;第三军医大学第一附属医院临床创新基金资助项目（NO.2006A006）

摘　　要：目的 观察视网膜色素变性（RP）患者视锥细胞和视杆细胞的多焦视网膜电图（mfERG）特征，评估感光细胞功能。方法 选取正常受试者8例8只眼进行视杆细胞mfERG检查，分析不同刺激光亮度对P1波振幅的影响；对19例RP患者38只眼分别进行视杆和视锥细胞mfERG检查，根据局部波形信噪比判断检出率，对视锥细胞mfERG不同类型间的平均视力、P1波振幅密度进行比较和统计学分析。同时对比分析RP患者视杆和视锥细胞mfERG在各象限P1波振幅的变化。结果 采用0.04 cd/m^2蓝色低刺激光亮度可以稳定记录正常人视杆细胞mfERG反应。RP患者视锥和视杆细胞mfERG有效波形检出率分别为65.79%和10.51%。视锥mfERGⅠ型P1波振幅密度高于Ⅱ型，差异有统计学意义（t=5.21,P=0.000），平均视力差异无统计学意义（t=1.15, P=0.612），I型振幅密度与logMAR视力呈负相关（r=-0.48，P=0.04）。分别比较RP患者视锥和视杆mfERG局部波形特征发现，两者在各象限的P1振幅密度在空间上有一定的对应性。结论 RP患者黄斑区视锥细胞的反应存在多样性，视锥细胞mfERG检出率高于视杆细胞，残存视锥和视杆细胞功能在空间上有一定的对应性。Objective To observe the mutifocal electroretinogram （mfERG） characteristics of rod and cone cells in patients with retinitis pigmentosa （RP） and to evaluate the function of photosensory cell.Methods The mfERG recording technique for rod cell in eight normal subjects （eight eyes） were established and the influence of different brightness lightstimulus in P1 wave amplitude were analyzed. The cone and rod cells mfERG of 38 eyes in 19 patients were recorded and then calculated positive ratio from local signalnoise ratio. The average visual acuity and P1 wave amplitude density of cone mfERG in different types were compared and statistically analyzed. Meanwhile, the changes in P1 wave amplitude of cone and rod mfERG in four quadrants also compared and analyzed. Results Rod cell mfERG in normal subjects can be recorded stably by using blue flashes with low light intensity as 0.04 cd/m^2. In patients with RP, the cone and rod cells mfERG can be detectd 65.79% and 10.51% respectively. P1 wave amplitude density in type Ⅰ of cone cell mfERG was significantly higher than that in type Ⅱ （t=5.21,P=0.000）. There were no differences in average visual acuity （t=1.15, P=0.612）. P1 wave amplitude density in type Ⅰ was negatively related to logMAR visual acuity （r=-0.48,P=0.04）.The comparison of rod and cone cells mfERG in local wave characteristics showed that P1 wave amplitude densities had spatial relationship in each area. Conclusions The results suggested highly variable central responses in cone cell in RP patients, higher positive recorded ratio in cone cell than rod cell and spatial correspondence between the function of reserved cone and rod cells.

关 键 词：视网膜电描记术/利用 视网膜炎 色素性/诊断 

分 类 号：R774.1[医药卫生—眼科]