Multifocal electroretinography and fluorescein angiography in retinal vein occlusion

PURPOSE: To interpret the responses of multifocal electroretinography (mfERG) of the central macula in retinal vein occlusion and correlate them with findings of fluorescein angiography, optical coherence tomography (OCT), and visual acuity. METHODS: In a prospective observational case series, 25 patients with branch or hemiretinal vein occlusion were examined by means of mfERG, fluorescein angiography, OCT, and visual acuity. RESULTS: In eyes with macular ischemia shown by fluorescein angiography, the implicit time was significantly longer than that in eyes without macular ischemia (P = 0.006; Mann-Whitney test). The amplitudes in the first-order kernel responses in the ischemic eyes were more reduced (P = 0.04; Mann-Whitney test), and the amplitudes in the central macula correlated well with visual acuity (P = 0.006; Pearson correlation). There was no significant correlation between the degree of retinal thickening as measured by OCT and the mfERG responses, although there was a trend toward reduced amplitudes in the maculae with central retinal thickening (P = 0.08; Pearson correlation). CONCLUSION: Macular ischemia as measured by fluorescein angiography correlates well with the prolonged implicit time on the first-order kernel response in mfERG, but no significant correlation was detected between the responses of mfERG and the OCT findings. Further investigations will demonstrate if this can be used as a prognostic instrument in the selection of patients, who will most likely benefit from future treatments.     

Retinal disorders in northern Brazilian patients treated with chloroquine assessed by multifocal ERG

The effects of chloroquine intake on the retinal function in a Brazilian population of patients were assessed by multifocal electroretinography. Twenty-four randomly chosen eyes of patients treated with chloroquine for rheumatoid arthritis and systemic lupus erythematosus were examined using multifocal electroretinography (mfERG). Control measurements were acquired from 21 randomly chosen eyes of age-matched healthy subjects. None of the study participants had an inherited retinal disease or a Snellen visual acuity reduced to less than 20/40. In patients and control subjects, cumulative chloroquine dose, total daily dose, duration of treatment, retinal examination, visual field defects, visual acuity, and the mfERG were assessed. The average amplitudes and implicit times of the N1, P1, and P2 components of the mfERGs were measured in the central hexagon (R1) and in five rings (R2–R6). The values measured in patients and normal subjects were compared. The P1 amplitudes in R2 were significantly decreased in the patients. In addition, the amplitudes of N1 and N2 in R1 were significantly smaller in the patients. The implicit times of none of the components were significantly different between patients and controls. The response amplitude was not significantly correlated with cumulative dose and duration of intake. There was no correlation with retinal appearance, visual field, and visual acuity. In agreement with earlier data, the central mfERG amplitudes were decreased in chloroquine patients indicating functional alterations in the retina. These changes are also present in a Brazilian population suggesting that the effects of chloroquine are general and that genetic background and life circumstances probably have, if at all, only little effect.     

Assessing Responses of the Macula in Patients with Macular Holes using a New System Measuring Localized Visual Acuity and the mfERG

Purpose: To evaluate acuity and multifocal electroretinogram (mfERG) responses from the macula in affected and unaffected fellow eyes of patients with macular holes. Methods: We tested 10 eyes with macular hole and 10 fellow eyes from 11 patients. We measured local visual acuity thresholds at 27 discrete locations within 21° diameter using the Functional Fundus Imaging System (FFIS), a psychophysical system that measures visual acuity as a function of visual field location, and local ERG responses within 45° diameter using the mfERG. Results: In the affected eyes, the mean FFIS visual acuity thresholds were significantly elevated within the central 21° diameter area, compared to a group of control eyes. No significant differences were found between the acuities of the fellow eyes compared to those of the control group. The amplitudes of the first positive peak of the mfERG were reduced in the central 7.8° in affected eyes. In the central 2°, 4 out of 10 affected eyes showed non-measurable ERG signals. The remaining six eyes showed significantly reduced mean amplitudes, but not delayed implicit times, when compared to the control group. For the fellow eyes, the mean amplitudes of the mfERG and implicit times did not differ from the means of the control eyes. Conclusions: Both local psychophysical and electrophysiological testing demonstrated retinal dysfunction extending beyond the site of the macular holes in some patients (three of the patients had central mfERG amplitudes falling within the normal range).     

多焦视网膜电图在Vogt一小柳原田病急性期及恢复期随访中的应用

背景应用多焦视网膜电图（mfERG）评价急性期Vogt—Koyanagi-Harada（VKH）病的视网膜功能已有研究和报道,但VKH病恢复期mfERG如何变化文献报道不多。目的观察及随访VKH病急性期与恢复期视力及mfERG的变化特点。方法为回顾性临床对照研究设计,纳入在中山大学中山眼科中心确诊为VKH病急性期患者18例35眼,对患者的视力、mfERG及荧光素眼底血管造影（FFA）检查,并对VKH恢复期患者随访18个月,重复上述检查4次,对正常人、VKH急性期和恢复期患者的mfERG结果进行比较。结果本组急性期VKH病患者视力在0．01～1．0之间,仅1眼（2．86％）视力为1．0,91．4％（32／35眼）视力〈0．6,较正常对照组视力下降,差异有统计学意义（P〈0．01）。正常对照组、VKH急性期组和恢复期组患者mfERG1～6环的N1、P1波反应密度的总体差异比较均有统计学意义（P〈0．05）;与正常对照组比较,VKH急性期组和恢复期组患者mfERG1—6环的N1、P1波反应密度均明显降低,差异有统计学意义（P〈0．05）,但各环振幅降低的幅度不同,以1～3环降低最为严重,1环P1波振幅仅有正常对照的22％,随离心度增加,振幅降低逐渐减轻。与VKH急性期组相比较,恢复期组（2个月）患者视力为0．1～1．2之间,50％视力≥1．0,mfERGN1、P1波反应密度的提高以1～2环显著,与急性期相比差异均有统计学意义（P〈0．05）;但各环mfERGN1、P1波反应密度仍与正常有很大差异,总体仅及正常振幅的44％。VKH恢复期患者4次随访结果显示,患眼各期视力稳定,mfERG各波振幅有轻度下降趋势,但差异无统计学意义（P〉0．05）;3环内N1、P1隐含时缩短,4次随访总体差异有统计学意义（P〈0．05）。结论VKH对患者视力及后极部视网膜功能有严重影响,黄斑区是疾病影响最为严重且治疗前后功能变化较大的部位。治疗后即使视力恢复较理想,但mfERG结果证实视网膜功能仍有较大程度损害。     

单眼视网膜静脉阻塞患者对侧眼黄斑功能的多焦视网膜电图检测

目的 观察单眼视网膜静脉阻塞(RVO)患者对侧眼黄斑功能的变化.方法 对比分析24例经荧光素眼底血管造影(FFA)确诊为单眼RVO患者的24只对侧眼及18位正常受试者18只正常眼的多焦视网膜电图(mfERG)检测结果,比较两组受试者黄斑功能的差异.采用罗兰RETIsean电生理仪记录mfERG,将记录图形分别按照6个同心圆和4个象限对P1、N1波的振幅密度及潜伏期进行比较和分析.结果 RVO患者对侧眼在中心第1、2环处P1、N1波的振幅密度显著低于正常眼,差异有统计学意义(t=4.520,2.147;P＜0.05);其它各环、各象限振幅密度及潜伏期在两组间均未见明显差异(P＞0.05).结论 与正常眼相比,RVO患者对侧眼黄斑中心凹视功能受损.     

Assessment of retinal function in patients with HIV without infectious retinitis by multifocal electroretinogram and automated perimetry

PURPOSE: To determine if multifocal electroretinogram (mfERG) testing shows abnormalities that correspond to perimetric defects in HIV positive patients without infectious retinitis. METHODS: We studied three groups of patients: HIV negative controls, HIV high CD4 nadir patients (lowest CD4 T cell count is over 100) and low CD4 nadir patients (below 100 for over 6 months). Twenty-six HIV positive eyes and 16 HIV negative control eyes were studied by mfERG. A subset of 10 eyes also underwent computerized perimetry for comparison. We analyzed mfERG by hexagons as well as by quadrants and rings. RESULTS: Of 103 hexagon locations there was no significant difference in the amplitudes P1 and N1 (nV/degree) between the three studied groups (p>0.05), similarly, the latencies were not different (p>0.05). All eyes with significant visual field defects at the 0.01 and 0.005 level (Humphrey pattern deviation; 24-2) were compared to mfERG amplitudes and latencies at those locations-there were no corresponding defects in mfERG data (p>0.2). CONCLUSION: In the era of HAART there are still demonstrable visual field defects and other evidence of damage to the retinal nerve fiber layer in HIV patients. Our mfERG studies show that the damage appears to affect the inner retina, the outer retina is spared. Further studies of inner retinal structure and function are indicated to elucidate this process.     

First and second-order kernel multifocal electroretinography abnormalities in acute central serous chorioretinopathy

Purpose To evaluate the first and second-order kernel multifocal electroretinogram (mfERG) response abnormalities in patients with acute central serous chorioretinopathy (CSC). Methods This was a cross-sectional observational study in which 45 eyes of 45 patients with acute CSC underwent mfERG recordings. Peak amplitudes and implicit times of the first and second-order kernel responses were analyzed and compared with 20 age-matched normal controls. Correlation analyses were performed between the patients’ visual acuity and the first and second-order amplitudes and implicit times. Results The first-order N1 and P1 mfERG amplitudes in the central three concentric rings were reduced in eyes with acute CSC compared with controls (P < 0.05). The first-order P1 implicit times of the central four rings were also delayed (P < 0.05). For the second-order mfERG response, there were significant reductions in the second-order P1 and N1 amplitudes in rings 3–5 compared with controls (P < 0.05). No significant difference between the second-order P1 and N1 implicit times was found compared with controls (P > 0.05). Correlation analyses showed significant correlations between visual acuity and the first-order N1 response amplitudes of rings 1 and 2, and for the first-order N1 and P1 implicit times of rings 1–4 (P < 0.05). Conclusion Both first and second-order mfERG response abnormalities occur in eyes with acute CSC. These results suggest that in acute CSC, while outer retinal dysfunction is mostly localized to the central macula, there might be more widespread impairment in adaptive mechanisms of the inner retina or outer plexiform layer dysfunction in the more peripheral macula. Presented in part in the 44th annual symposium of the International Society of Clinical Electrophysiology of Vision (ISCEV), Fontevraud, France, June 2006.     

Transient reduction in retinal function revealed by multifocal electroretinogram after photodynamic therapy

PURPOSE: To evaluate the early changes in retinal function after photodynamic therapy (PDT) by multifocal electroretinogram (mfERG). DESIGN: Prospective interventional case series. METHODS: Seventeen eyes from 17 patients scheduled for standard PDT with verteporfin were prospectively recruited. Patients' diagnoses included choroidal neovascularization (CNV) secondary to age-related macular degeneration, idiopathic CNV, myopic CNV, polypoidal choroidal vasculopathy, and central serous chorioretinopathy. Serial mfERG recordings were performed before PDT, and at 4 days, 2 weeks, and 1 month after PDT. The first-order kernel N1 and P1 mfERG response from the central 0 to 7 degrees and peripheral 7 to 25 degrees were grouped and analyzed. The mean response amplitudes and peak latencies of the mfERG recordings were compared longitudinally. RESULTS: There were statistically significant reductions in the mean N1 response amplitude for the central group at 4 days (P =.007) and 2 weeks after PDT (P =.024), in the mean P1 response amplitude for both the central (P =.006) and peripheral (P =.013) groups at 4 days, and for the central group at 2 weeks after PDT (P =.017). There were also statistically significant increases in the mean P1 response latencies at 4 days (P =.004) and at 2 weeks (P =.018) after PDT for the central group and at 4 days after PDT (P =.026) for the peripheral group. At 1 month after PDT, no significant differences in the N1 and P1 mean response amplitudes and peak latencies were observed compared with pre-PDT mfERG. CONCLUSIONS: Transient impairments in retinal function for as long as 2 weeks after PDT were noticed by reduction in response amplitudes and a delay in peak latencies of mfERG. These findings may explain the common adverse event of subjective visual disturbance early after PDT with normal findings in visual acuity and ophthalmoscopy.     

Multifocal electroretinography in patients with exudative amd and intravitreal treatment with pegaptanib sodium

BACKGROUND: To objectively investigate central retinal function in patients with choroidal neovascularization (CNV) due to age-related macular degeneration (AMD) before and after treatment with pegaptanib sodium (PS). METHODS: Patients with CNV due to exudative AMD received intravitreal injections of 0.3 mg PS every sixth week if angiographic activity was evident. Longitudinal observation included recordings with multifocal electroretinography (mfERG) before the first treatment and before each injection at follow-up intervals. RESULTS: During the observation period of 30.5 +/- 8 weeks (mean +/- SD) a mean number of 5.3 +/- 1.3 injections were applied. Final mean log(MAR) visual acuity decreased, statistically nonsignificant, from 0.67 +/- 0.3 at baseline to 0.74 +/- 0.16. mfERG recordings in 12 patients after 25 +/- 9 weeks evinced a decrease in response density which was statistically significant in the central 5 degrees . Mean P1-amplitudes of ring 1, 2, and 3 were reduced by 66%, 39% and 30%, respectively. During follow-up, implicit times of the P1 components remained stable within 4% of baseline. In three of four patients with vision loss of 2 lines or more, P1-response amplitudes decreased substantially at least 6 weeks prior vision loss. CONCLUSION: Treatment with PS resulted in a decrease of central retinal function more obvious in mfERG than in VA longitudinal testing. Good correlations were seen between changes in mean vision and changes in mfERG response density components. As a decline in P1-response amplitudes anteceded vision loss in this study, our results indicate a possible role of mfERG to predict vision loss during intravitreal pharmacotherapy.     

多焦视网膜电图检测糖尿病早期视功能的变化

目的：了解多焦视网膜电图（mfERG）在糖尿病患早期视功能的变化规律。方法：将所有被检分为正常对照组（33例）、糖尿病无视网膜病变组（63例）以及单纯期糖尿病视网膜病变组（43例）。采用mfERG对上述3组进行检测，比较3组mfERG一阶反应N1波与P1波的潜伏期与反应密度。结果：在糖尿病无视网膜病变组中，N1波与P1波反应密度低于正常对照组，异常范围位于环1一环3。其中P。波反应密度在单纯期糖尿病视网膜病变组中进一步降低。N1波与P1波的潜伏期在糖尿病无视网膜病变组中的变化无统计学意义，在糖尿病视网膜病变组中延长，异常范围扩大到环4与环5。结论：mfERG在糖尿病视网膜病变出现之前已发生异常变化，且能够定量地反映随着病情的进展，视功能的损害程度及范围。     

Localized retinal dysfunction in central serous chorioretinopathy as measured using the multifocal electroretinogram

PURPOSE: To determine the extent of electrophysiologic dysfunction in patients with central serous chorioretinopathy (CSC). DESIGN: Prospective observational case series. PARTICIPANTS: Six patients with unilateral CSC (mean age, 40 years) were recruited into the study. METHODS: Six patients with CSC underwent multifocal electroretinogram (mfERG) testing on both their clinically affected and opposite uninvolved eyes using the VERIS System, with a stimulus array of 103 scaled hexagons. The first positive peak responses were analyzed within six concentric ring annuli centered on the fovea. Amplitudes and implicit times were compared with those of an age-similar control group. MAIN OUTCOME MEASURES: Local electroretinographic response amplitudes and implicit times within the central 40 degrees with the mfERG. RESULTS: All the clinically uninvolved eyes showed mfERG amplitudes and implicit times within the normal range throughout the central 40 degrees of the retina. All six eyes with CSC showed reduced amplitudes and/or delayed implicit times that were limited to the regions of the macula in which clinical changes associated with CSC were apparent. CONCLUSIONS: We observed electroretinographic changes only in the clinically affected eyes, and these were limited to regions with ophthalmoscopically apparent fundus changes. Our findings do not support the conclusion that functional impairment, as measured by the mfERG, in eyes with CSC extends beyond clinically observed fundus changes. We did not observe abnormal mfERG responses in the clinically normal eyes of such patients.     

Vogt-Koyanagi-Harada综合征多焦视网膜电图研究

目的 观察VKH(Vogt-Koyanagi-Harada,VKH)综合征急性期与恢复期后极部视网膜功能的变化特点.方法 对15例(30只眼)VKH综合征患者的急性期与恢复期进行mfERG测定,并与正常对照比较.结果 急性期VKH综合征患者各环mfERGN1、P1波振幅均有降低、多数环峰时延长,变化有统计学意义(P<0.05);各区域振幅降低幅度不同,以中心凹1环处降低最为严重,P1波振幅仅有正常对照的25%,随离心度增加,振幅降低逐渐减轻;与急性期相比较,恢复期1～3环mfERG振幅提高(P<0.05),4～6环振幅改变无统计学意义.与正常对照相比较,恢复期各环振幅降低仍有统计学意义;发生渗出性视网膜脱离与否,两组患者之间mfERG差异无统计学意义(P>0.05).结论 VKH对后极部视网膜功能有严重影响,即使治疗后视力恢复较理想,视网膜功能仍有较大程度损害.黄斑是治疗前后功能变化较大的部位.     

复杂性视网膜脱离的多焦视网膜电图研究

目的 探讨多焦视网膜电图（mfERG）对复杂性视网膜脱离（RD）视功能客观评价的意义。方法 应用VERIS ScienceTM 4．2mfERG检测仪对80例复杂性RD患者的双眼进行检测，并与正常对照组比较。结果 复杂性RD患者的对侧眼、患眼在6个环的N1波、P1波振幅密度较正常对照组降低，潜时延长，差异均有统计学意义（P〈0．01）。有严重玻璃体积血组的N1、P1波振幅密度在2～6环高于无严重玻璃体积血组，差异均有统计学意义（P〈0．05）。重度PVR组的N1、P1波振幅密度低于轻度PVR组，在6个环差异均有统计学意义（P〈0．05）。黄斑裂孔组在所有6个环的N1、P1波振幅密度较正常对照组降低，潜时延长，差异均有统计学意义（P〈0．01）。结论 mfERG能客观定量评价复杂性RD患者的视功能。严重的玻璃体积血、黄斑裂孔、PVR对视功能有明显影响。     

Central retinal vessel trunk exit and location of glaucomatous parapapillary atrophy in glaucoma

OBJECTIVE: To evaluate whether the position of the central retinal vessel trunk exit on the lamina cribrosa spatially correlates with the location of parapapillary atrophy in glaucoma. DESIGN: Clinic-based, observational, cross-sectional study. PATIENTS: Color stereo optic disc photographs of 95 patients with primary or secondary open-angle glaucoma and 65 healthy persons were morphometrically evaluated. The intrapapillary and parapapillary region was divided into four quadrants. We determined the position of the central retinal vessel trunk exit on the lamina cribrosa surface and measured the area of parapapillary atrophy and neuroretinal rim in the four quadrants. MAIN OUTCOME MEASURES: The area of neuroretinal rim and parapapillary atrophy and the position of the central retinal vessel trunk exit. RESULTS: Comparing measurements between opposite disc quadrants showed that beta zone of parapapillary atrophy was significantly (P < 0.05) larger and that the neuroretinal rim was significantly smaller when beta zone and neuroretinal rim were measured in the disc quadrant most distant to the central retinal vessel trunk exit, than if the beta zone and neuroretinal rim were measured in the quadrant containing the vessel trunk exit. Comparing measurements in the disc quadrants between eyes with different positions of the central retinal vessel trunk exit revealed that, in the respective disc quadrant, the beta zone was significantly larger and the neuroretinal rim was smaller in eyes with the vessel trunk exiting in the opposite disc quadrant than in eyes with the vessel trunk exit located in the respective disc quadrant where the measurements were obtained. CONCLUSIONS: Position of the central retinal vessel trunk exit on the lamina cribrosa influences the location of parapapillary atrophy in glaucoma. The longer the distance to the central retinal vessel trunk exit, the more enlarged is parapapillary atrophy and the smaller is the neuroretinal rim. This relationship agrees with the spatial relationship between glaucomatous neuroretinal rim loss and enlarged parapapillary atrophy in glaucoma. Diagnostically, it may indicate that, in eyes with an abnormal configuration of parapapillary atrophy or with an abnormal position of the central retinal vessel trunk exit, early glaucomatous rim changes should be looked for in the disc sector that is most distant to the central retinal vessel trunk exit and where parapapillary atrophy may be relatively large.     

视网膜色素变性患者视锥和视杆细胞多焦视网膜电图检测

目的 观察视网膜色素变性(RP)患者视锥细胞和视杆细胞的多焦视网膜电图(mfERG)特征.评估感光细胞功能.方法 选取正常受试者8例8只眼进行视杆细胞mfERG检查.分析不同刺激光亮度对P1波振幅的影响;对19例RP患者38只眼分别进行视杆和视锥细胞mfERG检查.根据局部波形信噪比判断检出率,对视锥细胞mfERG不同类型间的平均视力、P1波振幅惭度进行比较和统计学分析.同时对比分析RP患者视杆和视锥细胞mfERG在各象限P1波振幅的变化.结果 采用0.04 cd/m~2蓝色低刺激光亮度可以稳定记录正常人视杆细胞mfERG反应.RP患者视锥和视杆细胞mfERG有效波形检出率分别为65.79%和10.51%.视锥mfERG I型P1波振幅密度高于Ⅱ型,差异有统计学意义(t=5.21,P=0.0000),平均视力差异无统汁学意义(t=1.15,P=0.612).I型振幅密度与logMAR视力呈负相关(r=-0.48,P=0.04).分别比较RP患者视锥和视杆mfERG局部波形特征发现,两者在各象限的P_1振幅密度在空间上有一定的对应性.结论 RP患者黄斑区视锥细胞的反应存在多样性,视锥细胞mfERG检出率高于视杆细胞,残存视锥和视杆细胞功能在空间上有一定的对应性.     

Multifocal electroretinography in isolated arterially perfused bovine eye

AIM: To develop an isolated arterially perfused bovine eye as an in vitro model for studying retinal electrophysiology using multifocal electroretinography (mfERG). METHODS: Fresh bovine eyes were cannulated through the ophthalmic artery and perfused with oxygenated Krebs' solution at 37 degrees C within 15 min postmortem. Multifocal ERG was recorded using the veris 1.0 (Visual Evoked Response Imaging System). RESULTS: The mfERG waveform of in vitro bovine eyes had a typical trough (negative wave, N1) and peak (positive wave, P1) similar to those of human mfERG. The implicit times (peak latencies) for N1 and P1 were 20 and 42 ms respectively, and the average response amplitude (N1P1) was 55 nV. The implicit times of N1 and P1 were maintained for more than 4 h. The mfERG responses were affected proportionately by the stimulus intensity. Without a neutral density filter, the mean response amplitude was about 55 nV, which was diminished to 26, 18 and 10 nV under neutral density filters of 0.4, 1.0 and 1.4, respectively. Partial occlusion of the pupil completely abolished mfERG responses from the corresponding part of the retina. CONCLUSIONS: Isolated arterially perfused bovine eye may be used as an experimental model to study retinal electrophysiology using mfERG. The in vitro eye may offer a convenient and easily obtainable alternative to live animals, particularly for drug screening and invasive studies.     

Effect of glial cell line-derived neurotrophic factor on retinal function after experimental branch retinal vein occlusion

Purpose. The objective of the study was to investigate the effect of glial cell line-derived neurotrophic factor (GDNF) on the multifocal electroretinogram (mfERG) following an induced branch retinal vein occlusion (BRVO) in pigs. Methods. Electrophysiological examination of the retina was performed in 20 pigs with standard and four-frame mfERG 4 weeks after induced BRVO and intravitreal injection of GDNF or vehicle. BRVO was induced by intraocular diathermia of the superior retinal vein. Inner retinal function was measured by analysis of the four-frame mfERG (iN1) and outer retinal function with standard mfERG (P1). Results. In GDNF-treated BRVO eyes, P1 and iN1 amplitudes (P = 0.51 and 0.78) or implicit times (P = 0.08 and 0.99) did not differ from those in healthy fellow eyes. After vehicle injection, P1 and iN1 amplitudes of BRVO eyes were significantly lower than in the healthy fellow eye (P = 0.022 and 0.013). The log ratios of mfERG amplitudes between experimental and healthy fellow eyes were calculated (BRVO/healthy). GDNF improved the ratios of the four-frame mfERG (1.29 [0.88-1.88]) compared with vehicle (0.32 [0.21-0.50], P < 0.001). Equally, GDNF improved the ratios of the standard mfERG; GDNF (0.75 [0.51-1.10]) and vehicle (0.42 [0.27-0.63], P = 0.048). Conclusions. GDNF appears neuroprotective on retinal electrophysiological function after BRVO. The efficacy and safety of GDNF remain to be investigated in primate eyes.     

中心性浆液性脉络膜视网膜病变OCT与mfERG图像的相关性

目的利用光学相干断层扫描（OCT）与多焦视网膜电图（mfERG）分析中心性浆液性脉络膜视网膜病变（csc）患者的OCT与mfERG图像的关系。方法横断面研究。应用德国CarlZeissCirrusHD-OCT及美国EDI VERIS Science^TM4．9视诱发反应图像系统对40只急性期CSC眼（40例）进行检查。将CSC患者OCT黄斑厚度图三个环的视网膜平均厚度与相对应的多焦视网膜电图（mfERG）的1＋2环、3环、4环的N1、P1波的平均反应密度和峰时间进行比较,并将黄斑区体积、总的黄斑中心凹的厚度、视网膜下液高度、视网膜下液范围和中心凹神经上皮厚度与mfERG6个环的N1、P1波反应密度和潜伏期比较分析。采用Spearman秩相关进行数据分析。结果CSC患者OCT内环、中环、外环的视网膜平均厚度与mfERG1＋2环、3环、4环的N1、P1波的峰时间呈正相关。黄斑区体积、总的黄斑中心凹的厚度、视网膜下液高度和视网膜下液范围与mfERG的N1、P1波反应密度和峰时间有显著的相关性。结论CSC患者的黄斑平均视网膜厚度及积液情况与mfERG之间有一定的相关性,可用OCT测量黄斑区视网膜下液的积液量,尤其是用积液范围来评估黄斑区视网膜功能的改变。OCT与mfERG的检测可以综合评价CSC患者的形态与功能的变化。     

屈光不正性弱视患者多焦视网膜电图一阶反应P1波特征分析

目的 研究屈光参差性弱视患者mfERG一阶反应P1波特征,探讨mfERG在弱视诊断中的应用价值.方法 采用罗兰RETIscan型电生理仪检测一组(15例)屈光参差性弱视患者mfERG,选择一阶反应第一环P1波为指标,计算其平均振幅密度(nV·deg-2)及潜伏期(ms),采用配对t检验比较弱视眼与对侧健眼的统计学差异.结果 弱视眼P1波平均振幅密度为(164.7±73.1)nV·deg-2,对侧健眼为(227.0±61.3)nV·deg-2,差异有统计学意义(t=2.554,P=0.016);弱视眼P1波平均潜伏期为(30.3±4.3)ms,对侧健眼为(34.4±3.2)ms,差异有统计学意义(t=2.92,P=0.007).结论 屈光参差性弱视患者弱视眼mtERG一阶反应第一环P1波有明显改变,提示弱视眼存在视网膜开-双极细胞功能及视觉信息传导异常,mfERG有可能用作弱视的诊断的客观指标.     

Cone pathway function in relation to asymmetric carotid artery stenosis: correlation to blood pressure

Purpose:  To examine retinal function in relation to retinal perfusion pressure in patients with carotid artery stenosis. Methods:  Thirteen patients with carotid artery stenosis without clinical eye disease underwent assessment of ophthalmic artery systolic blood pressure (OSP) by ocular pneumoplethysmography, carotid artery obstructive disease by ultrasonography, intraocular pressure by applanation tonometry, retinal perfusion by fluorescein angiography and retinal function by multifocal electroretinography (mfERG). Data analysis compared the eye on the most stenotic side with the fellow eye in the same patient. Results:  Ophthalmic systolic pressure was 95.8 ± 13.1 mmHg on the side with the highest degree of carotid artery stenosis (mean 94.0%) and 111.7 ± 10.3 mmHg in the fellow eyes on the side with the lesser degree of stenosis (mean 33.9%). Summed mfERG implicit times (N1 and P1) were 3.4% and 2.0% longer (p = 0.013 and 0.021), and N1 and P1 amplitudes were 18.0% and 16.0% (p = 0.0041 and 0.020) lower in eyes on the side with the higher stenosis compared with the contralateral eyes. Shorter implicit times and higher amplitudes were correlated with higher brachial systolic arterial blood pressure (p = 0.0028, 0.011, 0.041 for N1, P1, N2 implicit times, respectively, and p = 0.0086, 0.016, 0.040 for N1, P1, N2 for amplitudes, respectively, corrected for OSP). Conclusion:  Cone function deviation was observed in clinically healthy eyes on the side with highest degree of carotid artery stenosis and was found correlated to arterial blood pressure.