视网膜脱离眼的黄斑局部视网膜电图频谱分析  

Fourier analysis of macular local electroretinogram in retinal detachment

作　　者：吴星伟[1] 张皙[1] 许迅[1] 宫媛媛[1] 孙勇[1] 朱萍[1] 

机构地区：[1]上海市第一人民医院上海市眼科研究所,200080

出　　处：《中华医学杂志》2001年第3期132-134,共3页National Medical Journal of China

基　　金：国家自然科学青年基金资助项目! (3 93 0 0 0 40 );上海市科技启明星计划基金资助项目! (95QB14 0 3 1)

摘　　要：目的　了解视网膜脱离 (RD)眼黄斑部光感受器细胞与光感受器后神经元细胞功能异常的情况。方法　 12 0例RD患者 12 8只眼的LERG被记录分析 ,应用手提眼底镜式局部刺激器通过放大的瞳孔直视眼底监控固视状况 ,闪烁光频率 31Hz。结果　与对照组相比 ,LERG的基波 (1f)与二次谐波 (2f)在RD眼振幅降低。 1f的异常率在发病时间 <1周组、1～周组、2～周组与 4～周与 8周以上组分别为 15 %、2 5 %、47%、76 %和 91% ,1f/ 2f的异常率为 5 %、14%、2 8%、6 4%和 87%。随着发病时间的延迟 ,2f的下降较 1f更明显 ,1f/ 2f呈升高趋势。在眼底镜下黄斑部脱离 (4 8眼 )与不脱离 (80眼 )两组中 ,1f与 2f的下降差异有显著意义 (P <0 0 5 ) ,2f在前组的下降差异有非常显著意义 (P <0 0 1) ,而在后组则无显著变化 (P >0 0 5 ) ,黄斑部脱离组的 1f/ 2f比值升高 (P <0 0 5 )。手术后最佳矫正视力与复位前的LERG振幅有显著相关。结论　RD眼的黄斑部光感受器细胞与光感受器后神经元的功能损害同时存在 ,RD伴黄斑脱离者的视网膜内层功能受损程度明显增加 ,RD眼的LERG振幅与解剖复位后的视功能恢复有显著相关。Objective To understand the sites and physiological characteristics of macular dysfunction in retinal detachment (RD) by evaluating fundamental harmonic (1f) and second harmonic (2f) components of flicker local electroretinogram (LERG). Methods LERG were recorded in 128 eyes of 120 patients to a flicker sinusoidally to 31Hz with a hand-held stimulator with direct visualization of the fundus through dilated pupils. Results Compared to controls, patients showed losses of both fundamental and second harmonic amplitudes. The abnormality rates of fundamental amplitude in groups with RD affected time <1 weeks, 1～ weeks, 2～ weeks, 4～ weeks and >8 weeks were 15%, 25%, 47%, 76% and 91% respectively; and the abnormality of rates fundamental-second harmonic amplitude ratios (1f/2f) were 5%, 14%, 28%, 64% and 87% respectively. On average, 2f decreased more quikly than 1f and 1f/2f tended to increase with the course of disease. The results show both 1f and 2f descend in the RD eyes with or no macular detachment(P<0.05). 2f just descend obviously in the 48 macular detachment eyes (P<0.01), so that 1f/2f ascend in these eyes(P<0.05). There was a significant relation between amplitudes of LERG in the detached eyes before surgery and best postoperational correct vision in the attached eyes. Conclusion In the eyes with retinal detachment, both receptoral and postreceptoral sites contribute to macular dysfunction. The level of macular dysfunction in the eyes with or no macular detachment is different. It would be of clinical value to obtain a fundamental-second harmonic ratio in order to assess the disturbance in the different site of macular. In our opinion: macular flicker local electroretinogram is an important indicator of prognosis to the functional recovery of the attached eye after corrective surgery.

关 键 词：视网膜脱离 黄斑 视网膜电图频谱分析 

分 类 号：R774.12[医药卫生—眼科]