黄斑水肿对视锥细胞功能损伤的研究  

Macular Edema Causes Cone Dysfunction

作　　者：金昱[1] 刘淼[1] 刘维峰[1] 石安娜[1] 石浔[1] 廖晓捷[1] JIN Yu;LIU Miao;LIU Wei-feng;SHI An-na;SHI Xue;LIAO Xiao-jie

机构地区：[1]南昌市第一医院眼科,南昌330008

出　　处：《实用临床医学（江西）》2016年第6期74-76,92,共4页Practical Clinical Medicine

摘　　要：目的通过多焦视网膜电图(multifocal electroretinogram,mfERG)对黄斑水肿患者的视网膜后极部不同部位视锥细胞功能进行检测,客观定量评估黄斑水肿对视锥细胞的功能损伤情况。方法将80例(共129眼)黄斑水肿患者根据眼底荧光造影(fundus fluorescein angiography,FFA)结果分为弥漫性黄斑水肿组(A组)43例(共69眼)和黄斑囊样水肿组(B组)37例(共60眼),同时选择健康体检者27例(共38眼)为正常对照组(C组)。对所有受试眼采用mfERG检测,记录6个环状视网膜区域的N1、P1波潜伏期和平均反应密度。结果 A、B 2组mfERG6个环状视网膜区域的N1、P1波潜伏期均较C组明显延迟(P<0.05),平均反应密度均较C组显著降低(P<0.05)。A组与B组mfERG 6个环状视网膜区域的N1、P1波潜伏期比较差异无统计学意义(P>0.05);但A组N1波平均反应密度在5—6环较B组显著降低(P<0.05),P1波平均反应密度在4—6环较B组显著降低(P<0.05)。结论黄斑水肿可引起视网膜后极部不同部位视锥细胞功能的严重损伤,而弥漫性黄斑水肿累及黄斑及周围区域较黄斑囊样水肿范围广,其对中心凹旁和中心凹外视锥细胞损伤更严重。Objective To determine the function of cones at the posterior pole of retina in patients with macular edema by using multifocal electroretinography(mfERG) ,and to quantitatively evaluate the effect of macular edema on cone function. Methods According to the results of fundus fluorescein angiography,80 patients with macular edema(129 eyes) were divided into diffuse macular edema group(group A ,43 patients,69 eyes) and cystoid macular edema group(group B,37 patients,6〇 eyes). In addition,27 healthy subjects(38 eyes) were selected as the control group (group C). The mfERG was performed to record the latencies and average response densities of N1 and PI waves in six annular areas. Results Compared with group C, the latencies of N1 and PI waves were prolonged and the average response densities of N1 and PI waves were decreased in both group A and group B(P<C〇. 05). However,there were no significant differences in the latencies of N1 and PI waves between group A and group B (P > 0 . 05). Compared with group B ,the average response densities of N1 wave at 5-6 annuluses and PI wave at 4-6 annuluses were reduced in group A(P<C0. 05). Conclusion Macular edema can cause serious cone dysfunction.However, diffuse macular edema involves wider range of macula and surrounding area and induces more serious damage to cones beside and outside of the central fovea.

关 键 词：黄斑水肿 视锥细胞 多焦视网膜电图 

分 类 号：R774.5[医药卫生—眼科]