黄斑病变的M-ERG初步观察  

Multi-focal ERG on macular diseases

作　　者：严良[1] 陆豪[1] 丁琦[1] 刘瑞珏[2] 

机构地区：[1]上海市宝山中心医院眼科,200190 [2]上海二医科大学附属第九医院眼科

出　　处：《中国实用眼科杂志》2002年第2期107-110,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :应用多焦视网膜电图 (M ERG)观察视网膜功能。方法 :对 16例 (16眼 )经眼底荧光素造影证实的单眼黄斑区病变 (中浆、老年性黄斑病变、外伤性黄斑出血等 )者分别应用二进制短M序列记录多焦视网膜电图 (RETIscanMultifocalERG ,M ERG)及按ISCEV标准记录全视野闪光视网膜电图(GanzfeldF ERG) ,分析患眼与对侧眼的M ERG一阶kernel反应 (FOK )、F ERG混合最大反应 (MCR) ,评价其视网膜功能。结果 :16例黄斑区病变眼的M ERG中心 1环P1波振幅密度值较对侧 (正常 )眼明显降低 (P <0 0 1)、峰潜时缩短 (0 0 1<P<0 0 5 ) ,2～ 5环的P1波振幅密度值和峰潜时则无明显差异 (P >0 0 5 ) ;而F ERGa、b波振幅、峰潜时与对侧正常眼比较差别无统计学意义 (P >0 0 5 ) ;正常眼M ERG中心 1环的P1波振幅密度值最大、峰潜时最长。结论 :黄斑区病变可使M ERG中心 1环 (黄斑中心凹周围 0～ 5°区域 )的一阶kernel反应振幅降低、峰潜时缩短 ;短M序列记录时程短、采样少 ,可能更适合固视力差或检查欠合作者 ;M ERG通过不同的kernel反应可反映视网膜外层 (感光细胞层 )和内层 (神经节细胞等 )的功能 ,对评价后极部尤其是黄斑区视网膜功能有独特作用 ,其优越性大于全视野ERG。Objective:To observe the retinal function of macular disease with multi focal electroretinogram (M ERG). Methods:16 patients with monocular macular diseases (central serous retinopathy,senile macular degeneration,traumatic macular hemorrhage) were applied the M ERG with short binary M sequence and the full field F ERG (Ganzfeld F ERG) with ISCEV standard,respectively.The first order kernel (FOK) of M ERG and the maximal combined response (MCR) between affected eye and normal eye of F ERG were analyzed,and the retinal functions were evaluated. Results:In all affected eyes,the P1 wave amplitudes of M ERG in ring1 were significantly declined (P<0 01),and the latencies were shortened than that of the fellow normal eye (0 01<P<0 05),whereas from ring2 to ring5,the amplitudes and latencies of the P1 waves between the two eyes had no statistic differences (P>0 05).The amplitudes and latencies of the MCR of F ERG a,b waves had no statistic differences (P>0 05).In normal eye,the P1 wave of ring1 had the highest amplitude and the longest latency among all rings. Conclusions:Macular diseases can decline the amplitude and shorten the latency of the central ring1 (0～5°) area around the macular fovea of FOK.Short binary M sequence recording that has shorter cycle and fewer samples may more suitable for the patient who has poor fixation capability or bad test cooperation.With different kernel responses,M ERG can reflect the functions of the outer layer (photoreceptor layer) and the inner layer (ganglion cell layer) of the retina.It is unique to evaluate the posterior pole,especially the macular retinal function,which is superior to the ordinary Ganzfeld ERG.

关 键 词：多焦视网膜电图 全视野视网膜电图 黄斑病变 视网膜功能 

分 类 号：R774.5[医药卫生—眼科]