黄斑裂孔手术前后固视、微视野和mERG的检测  

The evaluation of fixation, microscotometry and mERG examination in pre and postoperation of macular hole

作　　者：陈晶华[1] 黎晓新[1] 徐秀兰[1] 

机构地区：[1]北京大学人民医院眼科,100044

出　　处：《眼科研究》2002年第4期328-331,共4页Chinese Ophthalmic Research

摘　　要：目的 用激光扫描眼底镜检测黄斑裂孔手术前后固视、微视野和多焦视网膜电图（mERG）,比较这几种方法评价黄斑功能的可靠性。方法 实验采集了因老年特发黄斑裂孔,行玻璃体切割术治疗后,黄斑裂孔闭合的12例患者,手术前后的固视、微视野、mERG的检测资料。用Rodenstock的激光扫描眼底镜（SLO）进行周视和微视野的检测。用Rodenstock的RETlsean3.12系统进行mERG测定24°视野范围的一阶反应（first-order　kernel）。结果12例黄斑裂孔患考术后远视力提高6例,不变4例,下变2例;近视力提高9例,不变2例,下降1例。术前为非小心凹注视10例。术后注视改善7例,无改善3例;术前即为中心凹注视2例。术后光敏度较术前有明显提高,P<0.05。mERG:黄斑裂孔术前三维视觉山表现为火山口形状,术后黄斑裂孔闭合可观察到观觉山恢复的患者4例,术后观觉山形状无明显改善8例。mERG的中心 1、2环的值手术前后无明显改变,P>0.05。结论 手术后的远近视力较术的均有所提高;固视和微视野对于检测黄斑功能的改变比较敏感,其中微视野改善在明显.mERG无明显改变,在检测黄斑功能方面受到变异性、固视等诸多因素影响。Objective To compare the reliability of fixation , microscotornelry and multifocal electroretinogram ( mERG ) examination for evaluating macular function by analyzing the results of operation oi macular hole. Methods Twelve patients with age-related macular hole were chosen by this study. The macular hole ol these patients had been closed after vilrectomy in our hospital during 1999 and 2000. Scanning laser ophthalmoscope of Kodenstock was used to study fixation and scotometry. RETIscan3. 12 system was used to carry out mERG examination. First-order kernel was selected. Results Six eyes had better distant vision. Four eyes stabilized while 2 eyes became worse. Nine eyes had improved near vision. Two eyes were the same while one eye dropped. All eyes but 2 had non-fovea fixation before operation. Seven cases got improved fixation while three cases remained the same. The light sensitivity of these eyes got much better, P < 0. 05. Four eyes had a volcano-shape ER(/ topography pre-operatively arid regained spiky peak post-operatively. The other eight eyes had no improvement. The results of mERG from first and second ring before and after operation had no significant difference, P > 0. 05. Conclusions Both the distant and near vision of eyes with macular hole had been improved alter operation. Near vision can reflect central visual acuity belter. Fixation and niicroscolomelry are sensitive to the functional change ol macular. mERG had no significant change alter the operation. Its use in testing macular function is limited by variability ,fixation and other factors.

关 键 词：黄斑裂孔 固视 微视野 多焦视网膜电图 黄斑功能 激光扫描眼底镜 

分 类 号：R779.6[医药卫生—眼科]