合理选择视网膜电图检查指标客观了解内层视网膜的功能  

Towards objective assessment of the inner retinal functions

作　　者：雷博[1] 

机构地区：[1]重庆医科大学附属第一医院眼科眼科学重庆市重点实验室重庆市眼科研究所,400016

出　　处：《中华实验眼科杂志》2016年第4期289-292,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（81271033、81470621）;重庆市科委自然科学基金项目（2014pt-sy10002）;国家临床重点专科眼科建设项目

摘　　要：视网膜的解剖结构和生理功能非常复杂，目前临床上视网膜功能的客观评估主要依靠视网膜电图（ERG）。对主要累及外层视网膜的疾病，ERG可以准确判断病变所处的组织学部位，但对主要位于内层视网膜，即视细胞突触以后的视网膜病变，视觉电生理检查的辨识度尚远不及于外层视网膜，这是因为内层视网膜神经传导通路较长、内层视网膜也受外层视网膜视觉信号传人变化的影响以及视杆系统和视锥系统的反应存在相互影响，因此客观了解内层视网膜的功能是一个难点。近20年来，一些新的能够用于检测内层视网膜功能的ERG检测技术，如振荡电位（OPs）、ON．OFF反应、明视负波反应（PhNR）、暗视阈值反应（STR）等已用于临床，这些ERG指标主要起源于双极细胞、无长突细胞和视网膜神经节细胞，是评估内层视网膜疾病的有用工具。临床眼科医师应充分了解这些ERG检测指标在内层视网膜疾病诊疗中的临床意义，从而更好地指导临床诊疗工作。Retinal anatomic structure and physiology function are very complex. Electroretinogram （ERG） is currently the only objective assessment for retinal function. There are groups of devastating diseases characterized by affecting the inner retinal functions. However, compared with its advantages in evaluating the outer retina function, ERG is less sensitive in judging the inner retinal function. The decrease of sensitivity is mainly associated with the crosstalk between the rod and cone systems in the longer visual signal pathways. In the past twenty years, new recording techniques in ERG analysis including oscillatory potentials,ON-OFF responses,photopic negative responses and scotopic threshold response have been developed. These ERG components are generated from the bipolar ceils, amacrine cells or retinal ganglion ceils and are becoming novel tools to assess the function of the inner retina. Ophthalmologists should fully understand the clinical significance of these ERG components in assessing inner retinal function to better guide the diagnosis and treatment of retinal diseases.

关 键 词：视网膜电图记录法 人 视网膜神经细胞/生理学 视功能 视网膜疾病/诊断 

分 类 号：R774.1[医药卫生—眼科]