特发性黄斑前膜光相干断层扫描与多焦视网膜电图的相关性研究  

Relationship between optical coherent tomography and multifocal electroretinogram in idiopathic macular epiretinal membrane

作　　者：何美芹[1] 徐延山[1] 王兰惠[1] 郑曰忠[1] 

机构地区：[1]天津医科大学眼科临床学院天津市眼科医院天津市眼科学与视觉科学重点实验室,天津300020

出　　处：《中国实用眼科杂志》2013年第3期259-262,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨特发性黄斑前膜（idiopathic macular epiretinal membrane，IMEM）的频域光相干断层扫描（frequency—domain optical coherent tomography，fdOCT）与多焦视网膜电图（muhifo．calelectroretinogram，mfERG）的特征、相关性以及与视力的关系。方法临床病例自身对照研究。收集2012年1月至5月就诊于天津市眼科医院，经检眼镜和fdOCT或荧光素眼底血管造影检查确诊的单侧特发性黄斑前膜患者30例，进行mfERG检查，对侧正常眼数据作为对照组，分析其黄斑区形态与功能的相关性，以及对视力的影响。结果30只患眼的最佳矫正视力（best-corrected visual acuitv，BCVA）为0．02-1．0（0．62±0．27），fdOCT显示黄斑中心凹、旁中心凹、中心凹周围区视网膜平均厚度与对侧眼比较，差异均有统计学意义（P枷．05）。mfERG各波反应与对侧眼比较，1～5环P1波的振幅密度和N1波的潜伏期差异有统计学意义（P〈0．05），N1波振幅密度除1、2环外，差异均无统计学意义。患眼组视力与所对应的黄斑中心凹视网膜厚度之间存在明显的负相关（r=-0．615，P=0．001）。视力与mfERG1环P1、N1波振幅无关，与潜伏期有关（P〈0．05）。结论IMEM导致中心凹视网膜越厚，视力越差，但与视功能损害程度不一致，OCT和mfERG联合应用能更全面地评估IMEM对黄斑区结构和功能的影响。ObJective To investigate the features and correlation of frequencydomain optical co- herent tomography （fdOCT） and multifocal electroretinogram （mfERG） in patients with idiopathic macular epiretinal membrane （IMEM）, and visual acuity. Methods Thirty patients with unilateral IMEM were collected, which diagnosed by visual acuity, ophthalmoscope, OCT or fundus fluorescein angiog- raphy in Tianjin Eye Hospital from January to May of 2012, and then checked mfERG. The data from Qontralateral normal eyes was used as the control group. The relationship between the results of macu!ar morphology and function were analyzed, and the effect on visual acuity was also includ- ed. Results The best-corrected visual acuities of 30 eyes ranged from 0.02 to 1.0 （average 0.62±0.27）. fdOCT revealed that there was significantly statistical difference in the retinal thickness about macular fovea, parafovea and perifovea between diseases eyes and contralateral eyes （P 〈0.05）. mfERG revealed that there was a significant difference in the amplitude densities of P1 wave and the latencies of N1 wave at ring 1 to 5 （P 〈0.05）. There was no statistical difference in the amplitude densities of N1 wave except ring 1 and 2. The foveal thickening was negatively correlated with visual acuity （r =-0.615, P =0.001）. The latencies of P1, N1 wave at ring 1 had effect on visu- al acuity （P 〈0.05）, however, the amplitude densities were not. Conclusions The visual acuity can be worse with the increase of central retinal thickness which caused by IMEM, but that is inconsis- tent with the degree of functional impairment. The combination of OCT and mfERG have better evaluation in the effect of IMEM on macular anatomical and functional outcomes.

关 键 词：黄斑区视网膜前膜 光相干断层扫描 多焦视网膜电图 一阶函数核 

分 类 号：R770.43[医药卫生—眼科]