多焦视网膜电图在中心性浆液性脉络膜视网膜病变中的临床研究  

The clinical research of central serous chorioretinopathy by multifocal electro-retinography

作　　者：叶琴[1] 郭健[1] 

机构地区：[1]福建医科大学附属第一医院眼科,中国福建省福州市350005

出　　处：《国际眼科杂志》2013年第7期1399-1402,共4页International Eye Science

基　　金：福建省教育厅科技项目(No.JA12141)~~

摘　　要：目的:通过多焦视网膜电图(multifocal electroretinography,mf-ERG)在中心性浆液性脉络膜视网膜病变(central serous chorioretinopathy,CSC)治疗前后的观察,提高CSC诊断的准确性,并指导临床诊疗,评估预后。方法:设置有比较性的CSC观察组和双眼正常的对照组。观察组有31例CSC患者都是单眼发病,这些患者每只眼(包括患眼与对侧眼)在发病期与恢复期都经过眼科的系统检查,包括最佳矫正视力、眼底荧光血管造影、OCT和mf-ERG,并记录这些检查的数据。对照组有30例,与观察组年龄范围相同,同样做上述检查并记录数据。对两组数据进行对比分析。结果:在CSC发病期,mf-ERG显示患眼平均视网膜振幅密度在1环为60.54±18.20nV/degree2,比对照组(110.94±31.20nV/degree2)低45.43%(P<0.01),在2环为38.12±10.81nV/degree2,比对照组(60.91±11.43nV/degree2)低37.42%(P<0.05)。在恢复期,mf-ERG显示患眼平均视网膜振幅密度在1环为93.71±14.13nV/degree2,比对照组(110.94±31.20nV/degree2)低15.53%(P<0.05);在2环为51.16±10.34nV/degree2,比对照组(60.91±11.43nV/degree2)低16.01%(P<0.05)。另外,我们还发现,观察组31例患者中有8例对侧眼也显示出异常,平均视网膜振幅密度在1环为62.41nV/degree2,其余23例患者对侧眼未发现异常。结论:多焦视网膜电图有助于中心性浆液性脉络膜视网膜病变患者的临床治疗与随访观察,对中心性浆液性脉络膜视网膜病变患者的诊断、病情评估及预后都起着重要的作用。AIM： To elevate the diagnostic accuracy and guide the clinical treatment of central serous chorioretinopathy （CSCR） by means of multifocal electroretinogram （mf-ERG） at presentation and after resolution of the acute phase. METHODS： A comparative observational case series group and a normal sample group were set. Thirty-one eyes of 31 patients with unilateral CSCR were examined. Both eyes underwent complete ophthalmological examination, which included measurement of best- corrected visual acuity, fluorescein angiography, OCT and mf-ERG recording. The results were compared with the corresponding findings of 30 normal volunteers of the same age. RESULTS： At presentation, the averaged mean retinal response density of the mr-ERG of the affected eyes in area 1 was 60. 54 ±18. 20 nV/degree2, 45. 43% lower compared to the normal controls （ P〈0.01 ）, and in area 2 was 38.12±10.81 nV/degree2, 37.42% lower compared to the normal controls （P〈0.05）. After regression of CSCR, the averaged mean retinal response density of the mf- ERG of the affected eyes in area 1 was 93.71 ±14. 13nV/ degree2, 15.53% lower compared to normal controls （P〈 0.05）, and in area 2 was 51.16±10.34 nV/degree2, 16.01%lower compared to the normal controls （P〈0.05）. It was interesting that 8 of 31 fellow non-affected eyes showed abnormal values, with an averaged mean retinal response density of mf-ERG in area 1 （62.41 nV/degree2）. In the remaining 23 eyes, the mf-ERG values were within normal limits. CONCLUSION. Multifocal electroretinography is favorable in the clinical treatment and the following observation of central serous chorioretinopathy. It may play an important role in the diagnosis, pathogenic condition evaluation and prognosis of CSC.

关 键 词：中心性浆液性脉络膜视网膜病变 多焦视网膜电图 

分 类 号：R774.1[医药卫生—眼科]