视觉眼电图诊断指标的相关性及临床应用

本实验对ＶＥＯＧ的十项判定指标进行了分析，发现ＱＡｒｄｅｎ、ＱＧｌｉｅｍ、ＰＤ／ＬＰＰ与ＤＴＰ的相关有显著性，ＱＡｒｄｅｎ、ＱＧｌｉｅｍ与ＰＤ相关性很显著，ＱＧｌｉｅｍ、ＰＤ／ＬＰＰ与ＱＡｒｄｅｎ的相关性非常显著。ＬＰＰ／ＢＶＰ与其他指标间的关系均无显著性。ＱＡｒｄｅｎ、ＱＧｌｉｅｍ、ＰＤ／ＬＰＰ与ＬＰＰ、ＤＴＴ、ＬＰＴ的相关也无显著性，表明在ＶＥＯＧ十项指标中以ＱＡｒｄｅｎ、ＰＤ／ＬＰＰ、ＱＧｌｉｅｍ、ＰＤ、ＤＴＰ较为重要，并在临床中得到了初步验证。     

视网膜电图检测对视网膜静脉阻塞视功能的评价

目的 探讨视网膜电图（ｅｌｅｃｔｒｏｒｅｔｉｏｇｒａｍ,ＥＲＧ）的检测对视网膜静脉阻塞（ｒｅｔｉｎａｌ ｖｅｉｎ ｏｃｃｌｕｓｉｏｎ,ＲＶＯ）视功能评价的可能性。方法 对２１例ＲＶＯ患者及２３例正常对照组分别进行ＥＲＧ检测,测ａ、ｂ波振幅、峰潜时和振汤电位振幅。结果 ＲＶＯ组最大反应ａ、ｂ波振幅对照组明显下降,峰潜时延长、振荡电位幅值也明显降低,ＣＲＶＯ与ＢＲＶＯ组间有显著差异,说明随病变程度而加     

电针对透镜诱导性近视豚鼠闪光视网膜电图的影响

目的　探讨电针对透镜诱导性近视豚鼠闪光视网膜电图（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ,ＥＲＧ）的影响。方法　２４只３周龄健康三色短毛豚鼠随机分为透镜诱导组（１２只）与透镜诱导＋电针组（１２只）。两组豚鼠右眼戴－１０Ｄ透镜,左眼不戴镜作为自身对照。透镜诱导＋电针组在戴镜的同时,电针刺激豚鼠两侧合谷穴与太阳穴。４周后测量２组屈光度、眼轴长度及ＥＲＧ波形的变化。结果　４周后,与自身对照眼比较,透镜诱导眼近视屈光度增加（Ｐ＜０．０１）,眼轴延长（Ｐ＜０．０１）;同时其暗适应振荡电位的ＯＳ２波振幅及总振幅下降（均为Ｐ＜０．０１）,暗适应最大混合反应、明适应视锥细胞反应的ｂ波振幅下降（均为Ｐ＜０.０１）。电针干预后,透镜诱导眼的屈光度和眼轴长度没有变化（Ｐ＞０．０５）;但与透镜诱导组右眼相比,透镜诱导＋电针组透镜诱导眼暗适应振荡电位的ＯＳ２波振幅及总振幅,暗适应最大混合反应、明适应视锥细胞反应的ｂ波振幅均增高（均为Ｐ＜０．０５）,达到与其自身对照眼相似的水平（均为Ｐ＞０．０５）。结论　电针刺激合谷穴与太阳穴影响透镜诱导性近视豚鼠ＥＲＧ,可使其恢复至正常水平。     

再适应视网膜电图——一种客观的暗适应功能检测方法

目的探讨用电生理方法检测糖尿病视网膜病变（ＤＲ）患者的暗适应过程。方法利用标准杆体反应的记录条件检测再适应视网膜电图（Ｒｅ－ＥＲＧ）。５２例正常眼Ｒｅ－ＥＲＧ的ｂ波振幅随暗适应时间的延长呈现由无到有、由小到大并趋于稳定的过程，达到最高值的时间平均为（２７．０８±２．５８）ｍｉｎ。结果不同时期的ＤＲ眼Ｒｅ－ＥＲＧ结果显示ＤＲ患者的暗适应功能下降，下降幅度与病变的严重程度呈平行关系。未出现ＤＲ的糖尿病患者组与正常组相比其Ｒｅ－ＥＲＧ的ｂ波振幅无统计学差异结论Ｒｅ－ＥＲＧ是一种客观的暗适应功能检测方法，但不能作为ＤＲ的早期诊断手段。     

视网膜电图在视网膜中央静脉阻塞分型中的应用价值

我们选择不同的刺激条件，对３２例早期视网膜中央静脉阻塞（ｃｅｎｔｒａｌｒｅｔｉｎａｌｖｅｉｎｏｃｃｌｕｓｉｏｎ，ＶＲＶＯ）患者进行视网膜电图（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＥＲＧ）的检测。缺血型ＣＲＶＯｌ３例的ａ、ｂ波潜伏期延长，ｂ波振幅明显下降；非缺血型ＣＲＶＯ１９例的ａ、ｂ波潜伏期延长，ｂ波振幅表现为轻度降低、升高或正常。提示ｂ波振幅和ｂ／ａ值是区分缺血型与非缺血型ＣＲＶＯ的最敏感指标。我们还探讨了ＥＲＧ在早期ＣＲＶＯ分型中的应用价值。     

视网膜电图对视网膜血管阻塞的功能评估

目的：用视网膜电图评估视网膜血管阻塞的功能改变。方法：３０例视网膜中央静脉阻塞,１５例视网膜分支静脉阻塞,７例视网膜中央动脉阻塞和６例视网膜分支动脉阻塞按照ＩＳＣＥＶ的ＥＲＧ标准进行全视野网膜电图的检测。用Ｉ１蓝光、Ｉ１６红光和Ｉ１６白光估计暗视ＥＲＧ,用Ｉ１６红光和Ｉ８白光估计明视ＥＲＧ。记录ａ波和ｂ波的振幅和潜伏期及震荡电位。结果：视网膜血管阻塞的震荡电位异常率最高,其次为ｂ波;ＥＲＧ的异常率     

视网膜脱离复位后的视网膜电图研究

目的 研究视网膜脱离（ＲＤ）复位后视网膜电图改变,探讨视功能损害的程度和部位。方法 １０只健康灰兔分为实验组４组８只,正常对照组２只。通过在视网膜下注射０．１％透明质酸钠方法建立ＲＤ模型。在术前和术后１,２,３,４周时分别记录视网膜电图。结果 暗视视杆细胞反应,最大反应ａ,ｂ波,单闪光明视锥细胞反应和闪烁光反应振幅,在视网膜复位后逐渐升高,复位１周时恢复到正常时的６０％～６５％,复位３周时视网膜ＥＲＧ恢复到７０％～９０％。暗视最大反应ａ波潜伏期在视网膜复位后２天,延长１０．９％,复位１周后逐渐恢复。ＯＰｓ和其它各波的潜伏期未见有显著改变（Ｐ〉０．０５）。结论 复位后的视网膜电图虽然逐渐恢复,但ａ,ｂ波的不完全恢复提示了光感受器和Ｍｕｌｌｅｒ细胞功能的改变。     

视网膜电图振荡电位波节个数分析

视网膜电图振荡电位波节个数分析解放军总医院眼科王红视网膜电图的振荡电位（ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍｓ－ｏｓｃｉｌｌａｔｏｒｙＰｏｔｅｎｔｉａｌｓ，简称ＥＲＧ－ｏＰｓ），是一项视网膜生理功能的检查，它反映了视网膜的血液循环状态。ＯＰＳ是ＥＲＧ中...     

眼钝伤后视神经的电生理改变

以３．５７Ｊ能量挫伤兔眼后，闪光视诱发电位（Ｆ－ＶＥＰ）峰时值延迟，振幅下降，至伤后１０周不能恢复正常。并致暗视视网膜电图（Ｄ－ＥＲＧ）ａ、ｂ波振幅下降，其中ｂ液下降明显，４周恢复。视网膜电图振荡电位（ＯＰｓ）的总和波幅下降程度不及ＥＲＧ严重。以上电生理改变均于伤后当时及３周明显。     

视电生理对视网膜静脉阻塞分型的临床意义

本文观察了３２例视网膜静脉阻塞病人患眼（静脉郁滞性视网膜病变与缺血性视网膜病变）与对侧健眼的暗视ＥＲＧ及振荡电位。发现（１）ｂ波波幅及ｂ／ａ值患眼较对侧眼显著下降，且ｂ波峰时值明显延长。（２）ＯＰＳ各波幅患眼较对侧眼显著下降，Ｏ１，Ｏ２，Ｏ４峰时值明显延长。（３）ＨＲ型较ＶＳＲ型ｂ波波幅及ｂ／ａ波波幅比值显著下降。（４）ＨＲ型较ＶＳＲ型Ｏ１，Ｏ２波幅值显著下降。这些对判断ＲＶＯ分型有价值，对不能行     

多焦视网膜电图在糖尿病视网膜病变不同病期诊断的应用

目的：评价多焦视网膜电图（ＭＥＲＧ）在糖尿病性视网膜病变（ＤＲ）不同期诊断的应用价值。方法：对２４名（３５眼）正常人及６３名（９６眼）糖尿病患者分别进行眼科常规检查、眼压测定、眼底荧光血管造影（ＦＦＡ）、Ｏｃｔｏｐｕｓ视野及ＭＥＲＧ检测,并对ＭＥＲＧ与视野进行相关性分析,对比ＭＥＲＧ与其他视网膜功能检查方法的异常检出率。结果：ＭＥＲＧ总反应波的Ｐ１波反应密度在临床未见ＤＲ（ＮＤＲ）的糖尿病患者低于     

Pattern ERG and psychophysical functions in Best's disease

The aim of the study was to asses the neurosensory retinal function in 12 patients (24 eyes) with different stages of Best's disease, by determining how pattern and full field flash ERG responses were related to visual acuity, stage of disease and extent of visual field loss. All patients had typically abnormal EOG responses and normal full field-flash ERG responses. Patients were stratified in two groups according to visual acuity. In the first group 12 eyes with visual acuity better than 0.5, all amplitudes and latencies of PERG P50 and N95 responses were in the normal range. Small central scotoma was detected by static perimetry in four of these eyes. In the second group of 12 eyes with visual acuity 0.5 or less, PERG showed reduced both P50 and N95 amplitudes in five eyes, and N95 solely, in two eyes. All patients had central scotomas detected by static perimetry. Progression of the disease, seen in deterioration of visual acuity and progression of central visual field defects, corresponded well with reduction of both PERG P50 and N95 amplitudes. There was no correlation found between visual acuity and EOG responses. Our results show that in Best's distrophy, pattern ERG is getting abnormal with progression of the disease, indicating relative preservation of neurosensory retina in initial stages of the disease. In contrast to EOG - being abnormal in all the patients regardless of the stage of disease - and full field-flash ERG - being normal in most of the patients - PERG gives opportunity for electrophysiological determination of the progression of the disease.     

Electrophysiological similarities between two eyes with X-linked recessive retinoschisis

Electroretinograms (ERG) and electro-oculograms (EOG) were studied in 88 eyes of 44 male patients with X-linked recessive retinoschisis. Differences of fundus appearance, ERG, and EOG between the eyes of each patient were analyzed. Fundus abnormalities were symmetrical in 77.3% of the cases. The amplitude of the ERG a-wave was normal in 26.1% and was abnormally low in 73.9%. The amplitude of the b-wave was below normal in all eyes; thus a small b-wave/a-wave ratio, which is characteristic of X-linked recessive retinoschisis, was observed in every case. The light peak to dark trough (LP/DT) ratio of the EOG was normal in 90.8% of the cases. The relative electrophysiological differences between the two eyes were calculated and showed that a-wave amplitude was not different between eyes in 75.0% of the cases; b-wave amplitude was not different in 77.3% of the cases; b-wave/a-wave ratio was symmetrical in 93.2% of the cases; and the LP/DT ratio was consistent between eyes in 86.8% of the cases. These results suggest that in most cases of X-linked recessive retinoschisis the fundus appearance, ERG, and EOG are similarly affected in both eyes of the patient.     

Simultaneous foveal and parafoveal electroretinograms in hereditary degeneration of the central retina

Simultaneous foveal and parafoveal electroretinograms (ERG) in response to two identical checks (6 degrees per side) alternating at constant mean luminance were recorded in 26 patients (52 eyes) affected by central hereditary chorioretinal diseases and in 14 age-matched normal subjects (14 eyes). Patients were divided into four groups according to clinical diagnoses: 1. Stargardt's disease; 2. cone dystrophy; 3. vitelliform degeneration; 4. pattern dystrophy. The amplitude and latency of the foveal ERG and the amplitude ratio between foveal and parafoveal ERG (FPF ratio) were measured. The mean foveal ERG amplitude was significantly lower than the control mean in all patient groups. The foveal ERG latency showed a trend to a increase in all pathological groups. However, this difference was not statistically significant. The mean value of FPF ratio was significantly reduced as compared with the control mean in Stargardt's disease and cone dystrophy only. In 46 of 52 affected eyes (88.5%) at least one of the electrophysiological parameters was abnormal. Our results suggest that the simultaneous foveal and parafoveal ERG recording may be a sensitive technique in hereditary degenerations of the central retina. This method may also contribute to a better understanding of cone degeneration pathophysiology.     

Electrofunctional features of the tilted disc syndrome

The ERG, EOG and VEPs of 15 patients with tilted disc syndrome were studied. The ERG showed abnormal amplitudes in about 1/4 of the eyes and the EOG values were pathological in 3 patients. It is probable that the abnormality of the inferiornasal portion of the retina and retinal pigment epithelium seen in the tilted disc syndrome causes the changes in the ERG and EOG. Pattern VEPs latency was delayed in most patients. This finding is probably due to the poor focusing of the light in the retina.     

Vigabatrin effect on inner retinal function

OBJECTIVE: To determine the degree of electroretinal dysfunction in a group of patients taking Vigabatrin (VGB). Additionally, to investigate the role of cumulative dosage, the role of VGB alone or in combination with other anticonvulsants, and whether recent discontinuance of VGB affects electroretinal function as measured by the electroretinogram (ERG). DESIGN: Retrospective, comparative case series. PARTICIPANTS: Forty patients (18 male, 22 female) with a mean age of 35 years were studied as three groups: the VGB multitherapy group (n = 24) included those taking VGB with other anticonvulsants, the VGB monotherapy group (n = 9) included those taking VGB alone, and the off-VGB group (n = 7) included those who had discontinued VGB in the last 6 months. METHODS: Scotopic flash, photopic flash, and 30-Hz flicker ERG results were recorded according to the International Society for Clinical Electrophysiology of Vision (ISCEV) standard. The clinical electro-oculogram (EOG) results were recorded according to the ISCEV standard. MAIN OUTCOME MEASURES: Implicit time and amplitudes of the A- and B-waves of the flash and 30-Hz flicker ERGs were recorded. Summed amplitude of the first three oscillatory potential wavelets were recorded. The light-peak to-dark-trough Arden ratio of the EOG was evaluated. RESULTS: Although photopic ERG B-wave reduction was most frequent in patients in the VGB multitherapy group (48% of eyes), a significant number of eyes in all three groups had scotopic ERG B-wave reduction. The 30-Hz flicker ERG result was abnormally reduced in all three groups. There was no significant difference in the frequency of occurrence in ERG result abnormalities between the VGB monotherapy and VGB multitherapy groups. The EOG results revealed reduced Arden ratios in all three groups; however, there was a significantly lower frequency of EOG abnormalities noted in the off-VGB group (P = 0. 0373). There was no statistically significant relationship between the frequency of electrodiagnostic abnormalities and the duration of use or the total cumulative dosage of Vigabatrin in any of the three groups. CONCLUSIONS: These findings of scotopic ERG result abnormalities suggest that VGB alone has an effect on inner electroretinal function at the level of the Müller cell. Concomitant EOG abnormalities suggest a substantial effect of VGB on outer retinal function that may be reversible after cessation of VGB treatment.     

干性年龄相关性黄斑变性的局部视网膜电流图研究

目的研究干性年龄相关性黄斑变性(Age—related macular degeneration AMD)患者的局部视网膜电流图(LERG)反应，探讨黄斑区视网膜功能损害的程度。方法对33例(60眼)干性AMD患者和18例(30眼)正常入应用稳态的闪烁光LERG和全视野暗适应闪光ERG检测。测量振幅和峰时。结果干性AMD患者LERG平均振幅显著下降，平均峰时明显延长，与正常对照组比较有显著差异。干性AMD患者全视野暗适应闪光ERG的a波、b波振幅和峰时与正常对照组无显著差异。结论干性AMD患者行LERG检测可直接了解其黄斑区视网膜外层功能，评估其病变程度有一定的临床意义。     

Retinal pigment epithelial dysfunction in human immunodeficiency virus-infected patients with cytomegalovirus retinitis

OBJECTIVE: Prior clinical observations led the authors to examine electrophysiologic measures of retinal (electroretinogram [ERG]) and retinal pigment epithelial (electro-oculogram [EOG]) function in patients infected with human immunodeficiency virus (HIV) who either had or did not have cytomegalovirus (CMV) retinitis in order to determine if the ERG or EOG measures were differentially affected in CMV retinitis. DESIGN: Cross-sectional study. PARTICIPANTS: Forty-one HIV-infected patients (20 with and 21 without CMV retinopathy) were evaluated. INTERVENTION: ERGs and EOGs were recorded. Patients' fundi were evaluated by indirect ophthalmoscopy or fundus photography. MAIN OUTCOME MEASURES: The ERG a- and b-wave amplitudes and EOG light/dark amplitude ratio (L/D ratio) from the eyes of all patients were compared with values 2 standard deviations from the mean of a normal sample. The area of the retinal lesions was estimated from fundus photographs or from careful drawings made during indirect ophthalmoscopy. RESULTS: The majority of the eyes (64.5%) of the patients with CMV retinitis had subnormal L/D ratios, and most eyes (95%) of patients without CMV retinitis had normal L/D ratios. Only six eyes (four with and two without CMV retinopathy) had subnormal a-wave amplitudes, and there was no significant correlation between a-wave amplitude and the L/D ratio for patients with CMV retinitis. Most eyes (80.6%) of the patients with CMV retinitis had subnormal b-wave amplitudes, but there was no significant correlation between b-wave amplitude and L/D ratio in the patients with CMV retinitis. In three patients with CMV retinitis selected to exemplify the range of effects on the ERG and EOG, the b-wave amplitude loss was roughly proportional to the area of retina visibly affected in indirect ophthalmoscopy. One patient had a nonrhegmatogenous retinal detachment. CONCLUSIONS: Middle retinal function, as reflected in the b-wave amplitude, and retinal pigment epithelial function, as reflected in the L/D ratio, were both compromised in CMV retinitis, but the effect on function in the two layers of the retina appeared independent because there was no significant correlation between the L/D ratio and b-wave amplitude. The decrease in L/D ratio was not secondary to loss of photoreceptor function and probably represents a dysfunction of the retinal pigment epithelium because there was no significant correlation between a-wave amplitude, which was normal in most cases, and L/D ratio. The inner retinal pathology of CMV retinitis is visible clinically and was associated with decreases in b-wave amplitude in this and previous studies. The significant independent retinal pigment epithelial dysfunction demonstrated in this study may be an important predisposing factor to retinal detachment in CMV retinitis.     

糖尿病患者的視網膜電圖分析

目的分析糖尿病患者F-ERG振幅、峰潜時、OPS總和振幅及其舆病程的相關性,以加深對DR的認識.方法采用美國UATA-2000型視覺電生理儀對53例糖尿病患者進行F-ERG檢查,主要分析其a、b波峰潜時、振幅,0PS總和振幅.結果隨着DR病情的加重,ERG及0PS無波的情况所占比例增大.a波峰潜時BDR組和正常組比較有極顯著性差异(P<0.01),BDR組和DM無DR組比較有顯著性差异(P<0.05);a波振幅正常對照組與其它各組比較均有極顯著性差异(P<0.01).b波振幅正常對照組與BDR、PDR間以及DM無DR組舆BDR、PDR組間均有極顯著性差异(P<0.01).0PS總和振幅除了BDR與PDR間外其它各組比較均有極顯著性差异(P<0.01).各指標舆病程之間均無明顯相關關系(經檢驗所有P>0.05).結論 0PS、ERG之a、b波振幅,尤其是b波振幅,可以作爲早期診斷DR患者以及估計預後的敏感指標,良好的血糖控制,可以延緩DM的病情發展.     

Helicoidal peripapillary chorioretinal degeneration: electrophysiology and psychophysics in 17 patients

AIMS—To characterise retinal function using electrophysiological and psychophysical tests in 17 patients with helicoidal peripapillary chorioretinal degeneration.
METHODS—The electroretinogram (ERG) was recorded using gold foil corneal electrodes. The electro-oculogram (EOG) was recorded using a standard protocol. Dark adaptometry was recorded with an SST-1 dark adaptometer and colour vision assessed with Ishihara plates and Farnsworth D-15.
RESULTS—All subjects had a recordable ERG. The amplitudes and implicit times of the a- and b-waves were within normal limits at all luminances in five subjects (age 21-70 years, mean 40 years). The ERG of six (age 26-55 years, mean 40.7 years) had subnormal amplitudes at all luminances, but normal implicit times, and six (age 38-81 years, mean 60.7 years) had abnormal ERGs with marked reduction of a- and b-waves, and delayed implicit times of the b-wave. The implicit times of the a-wave were normal in all subjects. A reduction in the b/a wave ratios was not found, nor was there selective loss of scotopic, mixed rod/cone, or cone responses. The light/dark ratio of the EOG was subnormal (150-185%) or abnormal (below 150%) in all but three subjects. Two patients with normal EOG showed normal ERGs in both eyes, but one had subnormal ERGs in both eyes. The scotopic sensitivity was normal in all subjects and dark adaptation showed a normal time course. Colour vision was normal in all patients.
CONCLUSION—The results suggest that in most cases the function of the retinal pigment epithelium is affected by this disease before any changes in the function of the sensory retina are detectable by our methods, and that retinal dysfunction is focal rather than diffuse.

Keywords: chorioretinal degeneration; electroretinogram; dark adaptation; colour vision