早期原发性开角型青光眼彩色图形视网膜电图的特征

目的观察早期原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）彩色图形视网膜电图（ｃｏｌｏｒｐａｔｔｅｒｎｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ，ＣＰ－ＥＲＧ）的改变特征。方法对２９例（４８只眼）ＰＯＡＧ，１０例（１６只眼）高眼压症及３３例（４８只眼）年龄匹配的正常人做ＣＰ－ＥＲＧ检测，并进行统计学比较及多因素分析。结果早期ＰＯＡＧ的ＣＰ－ＥＲＧ的Ｐ１、Ｎ２波幅下降，红黑Ｎ２与蓝黑Ｐ１峰时间延长；部分高眼压症已出现Ｎ２波幅下降。采用多因素逐步判别分析方法，筛选出对早期ＰＯＡＧ诊断有判别能力的５项指标：蓝黑Ｎ２波幅、红黑Ｐ１波幅、红黑Ｎ２波幅、红黑Ｎ２峰时间及白黑Ｐ１波幅与Ｎ２波幅的比值，同时建立了判别函数。结论ＣＰ－ＥＲＧ是检测早期ＰＯＡＧ视网膜功能改变的有效方法，有助于早期ＰＯＡＧ的诊断。     

定量测量视网膜神经纤维层厚度联合视觉电生理检查开角型青光眼

目的 比较光学相干断层成像术（ＯＣＴ）测量视网膜神经纤维层（ＲＮＦＬ）厚度与视觉电生理检查在原发性开角型青光眼（ＰＯＡＧ）早期损害中的敏感性并分析其间相互关系。方法 对早期、进展期或晚期ＰＯＡＧ患者２６例（５０眼）联合进行ＯＣＴ及ＰＥＲＧ、ＰＶＥＰ和ＯＰｓ的检查。结果 ＯＣＴ测量ＲＮＦＬ厚度在ＰＯＡＧ早期中的异常率为４０．９１％,低于ＰＥＲＧ（７８．９５％）和ＰＶＥＰ的异常率（６４．６４％）,高于ＯＰｓ（２８．５７％）。ＲＮＦＬ百度与ＰＶＥＰ和ＰＥＲＧ振幅显著正相关,与ＰＶＥＰ潜伏期负相关,与ＯＰｓ总值不相关。结论 联合ＯＣＴ测量ＲＮＦＬ厚度与视觉电生理检查更有利于青光眼的早期诊断。     

图象翻转视网膜电图在原发性开角型青光眼早期诊断方面的应用

图象翻转视网膜电图（Ｐ－ＥＲＧ）是近十几年兴起的电生理检查项目，起源于视网膜神经节细胞层，与原发性开角型青光眼视神经损害部位一致，故对原发性开角型青光眼有重要的诊断学意义。本文从开角型青光眼视神经损害机理、Ｐ－ＥＲＧ起源及与开角型青光眼视神经损害关系、Ｐ－ＥＲＧ检查条件及波型分析、Ｐ－ＥＲＧ对开角型青光眼早期诊断意义四方面复习综述了Ｐ－ＥＲＧ在原发性开角型青光眼早期诊断方面的应用。     

图象翻转视网膜电图在原发性开角型青光眼早期诊断方面的应用

图象翻转视网电图（Ｐ－ＥＲＧ）是近十几年兴起的电生理检查项目，起源于视网膜神经节细胞层，与原发性开角型青光眼视神经损害部位一致，故对原发性开角型青眼有重要的诊断学意义。本从开角型青光眼视神经损害机理、Ｐ－ＥＲＧ起源及与开角型青光眼视神经损害关系，Ｐ－ＥＲＧ检查条件及波型分析、Ｐ－ＥＲＧ对开角型青光眼早期诊断意义四方面复习综述了Ｐ－ＥＲＧ在原发性开角型青光眼早期诊断方面的应用。     

慢性开角型青光眼小梁切除术后眼血流动力学改变

目的 探讨原发性开角型青光眼（ＰＯＡＧ）小梁切除术后眼血流动力学改变。方法 用彩色多普勒（ＣＤＩ）检测ＰＯＡＧ小梁切除术前,后及非手术眼的视网膜中央动脉（ＣＲＡ）,眼动脉（ＯＡ）的血流动力学改变情况。结果 术后２周及３月ＣＲＡ平均血流速度（Ｖ ｍｅａｎ）和舒张末期血流速度（Ｖｍｉｎ）比术前增加,阻力指数（ＲＩ）下降,有显著性差异;ＯＡ在术后２周及３月仅Ｖｍｅａｎ比术前增加,ＲＩ下降,差异有显著性。     

图形视网膜电图检测原发性开角型青光眼视网膜功能的意义

目的 观察原发性开角型青光眼图形视网膜电图的改变及其特点,了解ＰＥＲＧ在检测ＰＯＡＧＰＹ视网膜功能方面的意义。方法 对３６例（５９只眼）ＰＯＡＧ及３２例（５９只眼）年龄相匹配的正常人进行ＰＥＢＧ检测。结果 ＰＯＡＧ患者ＰＥＲＧ的ＡＰ１、ＡＮ２、ＡＮ１、ＡＮ２／ＡＰ１下降;运用ＡＮ２＋ＡＰ１〈２．７及ＡＮ２／ＡＰ１下降;运用ＡＮ２＋ＡＰ１〈２．７及ＡＮ２／ＡＰ１〈０．７的方法,对已确认的ＰＯＡＧ进行     

原发性青光眼眼血管血流动力学的研究

采用Ｕｌｔｒａｍａｒｋ－９型双功能彩色多普勒超声仪对４０例（８０眼）正常人及４８例（９６眼）青光眼患者的眼动脉（ＯＡ），视网膜中央动脉（ＣＲＡ）的血流动力学参数进行检测对比，结果如下：低眼压青光眼（ＮＴＧ）和慢性开角型青光眼（ＣＯＡＧ）与正常组比较，除ＣＲＡ的平均血流速度（Ｖｍ）外，ＯＡ及ＣＲＡ的血流速度均明显减慢，ＮＴＧ及ＣＯＡＧ的眼动脉舒张末期血流速度（Ｖｄ）、视网膜中央动脉峰速（Ｖｓ）较慢闭角型青光眼（ＣＣＡＧ）明显减慢     

原发性开角型青光眼眼动脉视网膜中央动脉血流动力学及与荧光血管造影的关

用彩色多普勒成像技术（ＣＤＩ）分别检测了正常人和原发性开角型青光眼（ＰＯＡＧ）患者１０２只眼的眼动脉ＯＡ）和视网膜中央动脉（ＣＲＡ）的血流动动力学，结果表明ＰＯＡＧ患者ＯＡ和ＣＲＡ的收缩期最大血流速度、舒张末期血流速度和平均血流速度均比正常减少。而阻力指数正常增高。线性回归分析表明ＰＯＡＧ患者ＯＡ和ＣＲＡ舒张末期血流速度之间存在正相关关系。多元回归分析显示ＰＯＡＧ患者ＣＡＲ收缩期最大血流速度与荧光     

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。     

青光眼血流动力学变化及其相关因素研究

用彩色多普勒血流成像（ｃｏｌｏｒｄｏｐｐｌｅｒｆｏｌｗｉｍａｇｉｎｇ,ＣＤＦＩ）技术研究青光眼病人眼血流动力学变化及检测指标的可靠性。方法：采用美国Ａｃｕｓｏｎ－１２８ＸＰ型彩多普勒超声仪测量发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎ－ａｎｇｌｅｇｌａｕｃｏｍａ,ＰＯＡＧ）２５例,原发性闭角型青光眼（ｐｒｉｍａｒｙａｎｇｌｅ－ｃｌｏｓｅｇｌａｕｃｏｍａ,ＰＡＣＧ）３０例和正常人３０例的眼动脉（ｏｐｈ     

The Electrophysiology in Idiopathic Senile Macular Hole

Of 12 patients with idiopathic senile full- thickness macular hole, 3 had bilateral involvement, 9 had monocular macular hole. Flash ERG and pattern VEP were performed in the bilateral eyes of all patients. The abnormal rate of the pattern VEP was 93.3% when we used 15‘ checkboard stimulus, the changes of the VEP appeared as delayed latencies, reduced amplitudes or malformation of P100. The abnormal rate of the flash ERG was 53.3%, showing primary characteristics of reduced amplitudes of cone response b...     

P—ERG与盘沿面积测量在原发性开角型青光眼早期诊断中的应用比较

目的观察图形视网膜电图（P—ERG）检查与海德堡视网膜断层扫描仪（HRT—Ⅲ）测量盘沿面积在原发性开角型青光眼（POAG）的早期诊断中的应用价值。方法选择早期POAG患者25例（25只眼），可疑青光眼患者25例（25只眼），正常对照组25冽（25只眼），分别进行HRT—Ⅲ及P-ERG检查，观察检查结果异常率，并分析HRT-Ⅲ盘沿面积与P-ERG N95振幅的相互关系。结果在早期POAG组，P-ERG、HRT—Ⅲ检测异常率分别为72％、32％，差别具有显著意义（P〈0．05）；可疑青光眼组，HRT-Ⅲ、P-ERG检测异常率分别为20％、60％，差别具有显著意义（P〈0．05）；正常对照组，HRT-Ⅲ、P-ERG检测异常率分别为20％、12％，差别无显著意义（P〉0．05）。在早期POAG组，盘沿面积与N95波振幅在颞上、鼻下、鼻上区存在正相关，相关系数r分别为0．478、0．418、0．444；可疑青光眼组，盘沿面积与N95波振幅在颞下区存在正相关，相关系数r为0．496；正常对照组，盘沿面积与N95波振幅在鼻上，鼻下区存在正相关，相关系数r分别为0．449、0．438。结论在POAG的早期诊断中，P-ERG的检测异常率明显高于HRT-Ⅲ,且盘沿面积与N95波振幅存在一定相关性，联合检查将更有助于POAG的早期诊断。     

外伤性视网膜震荡的视觉电生理改变

目的：探讨外伤性视网膜震荡的视觉电生理改变。方法：对68例单眼外伤性视网膜震荡治疗前后的视觉诱发电位（VEP）及视网膜电图（ERG）改变进行观察。结果：外伤性视网膜震荡VEP异常率达91.18％,ERG异常率达85.29％,VEP和ERG联合检测异常率可达100％。电生理异常改变为,VEP P100波及ERG b波潜伏期延长（P＜0.05）,幅值降低（P＜0.01）;治疗后P100、b波均有明显改善,潜伏期（P＜0.05）,幅值（P＜0.01）。结论：提示VEP P100波、ERG b波可作为外伤性网膜震荡早期诊断有价值的观察指标,对病情判断、疗效观察亦有一定的临床意义。外伤性视网膜震荡电生理检查改变是可逆的。     

开角型青光眼早期手术的指征：视觉电生理联合检查的意义

目的 探索Ｐ－ＥＲＧ、ＯＰｓ和Ｐ－ＶＥＰ联合检查对开角型青光眼早期诊断的价值，以作为早期手术指征的参考。方法 对１２例（２０眼）可疑开青、３２例（５３眼）早期开青和３０例（６０眼）正常人进行上述三项检查。结果 在可疑开青组，其阳性率依次为５０％、２０％和１５％，联合检查的阳必性率为６５％；在早期开青组阳性率依次淡６２．２６％、４５．２８％和２８．３０％，联合检查为８５％。结论 联合检查较单一检查阳     

眼外伤异常电生理临床分析（附100例报告）

具有异常电生理改变的100例单眼外伤中,14眼仅VEP PT延长,显示黄斑、黄斑旁或视神经的钝伤,由FFA及视野加以证实.10眼VEP PT延长,PA下降或消失者显示黄班或视神经挫伤严重,可合并颅脑伤,视力严重下降或无光感.38例同时伴有FERGb波下降,显示损伤广泛而严重,可有眼球破裂、视网膜玻璃体及前房的出血,晶体混浊等.10眼VEP ERG波形全消失,则为眼球严重挫伤及伤后感染、眼球萎缩.28眼仅有FERGb波异常,则显示损伤不在中心区.     

视觉电生理联合应用对眼外伤视觉功能的评价

联合使用视觉电生理检查法评估外伤眼的视功能。方法单纯眼外伤３０例按受伤程度分３组,健康对侧眼为对照组,比较各组ＶＥＰＰ１００波潜伏值,３０Ｈｚ红闪炮光ＥＲＧ的振幅和暗适应ＥＲＧａ、ｂ波振幅的平均值。结论联合应用视觉电生理检测法是评价眼外伤视功能的可靠依据。     

The role of visual evoked potential and electroretinography in the preoperative assessment of osteo‐keratoprosthesis or osteo‐odonto‐keratoprosthesis surgery

Purpose: To determine the value of electroretinography (ERG) and visual evoked potential (VEP) in predicting visual outcome in patients undergoing osteo‐keratoprosthesis (OKP) or osteo‐odonto‐keratoprosthesis (OOKP) surgery. Methods: We performed a retrospective cohort study of 143 eyes in 101 patients who underwent OKP or OOKP surgery. The subjects underwent ERG, VEP testing or both up to 6 months prior to surgery. The ERG and VEP results were classified into four categories based on wave amplitude, latency and configuration. The main outcome was the maximum best‐corrected visual acuity (maxBCVA) reached at any time postoperatively. Results: One hundred thirty‐four cases had undergone preoperative ERG, 82 VEP and 73 both examinations. The sensitivities of ERG and VEP to detect maxBCVA ≥ 0.05 were 68.5% and 87%, respectively, while the specificity was 63.2% for ERG and 47.4% for VEP. The maxBCVA was significantly better in patients with normal ERG (p = 0.033) and those with normal VEP (p = 0.048), once having defined appropriate normal and abnormal cut‐off levels. When comparing fellow eyes in patients who underwent surgery in both eyes, maxBCVA was better in the eyes that had better VEP results (p = 0.013). Conclusion: Eyes demonstrating normal ERG or VEP achieved better visual outcome than those with abnormal results. In addition, VEP proved instrumental in determining the eye with the best prognosis when comparing both eyes of a given patient.     

年龄相关性萎缩型黄斑变性OCT和电生理检查的关系

目的将年龄相关性萎缩型黄斑变性患者黄斑区的OCT形态学检查及视觉电生理视功能检查相结合,探讨该病变黄斑部形态学改变与视功能改变之间的相互关系。方法选取初次诊断为年龄相关性萎缩型黄斑变性患者35例（40眼）以及同年龄段正常对照20例（40眼）,分别设为萎缩组和正常组。对两组分别进行黄斑中心凹的OCT检查及眼电生理检查,眼电生理检查包括视网膜电图（electroretinogram,ERG）和图形视觉诱发电位（pattern visual evoked potential,P-VEP）。采用独立样本t检验分析检查结果。结果①黄斑中心凹水平及垂直神经上皮层厚度：萎缩组与正常组差异无统计学意义（P〉0.05）。②暗适应ERG：萎缩组较正常组有b波潜伏期的延长（P〈0.05）和a、b波振幅的下降（P〈0.05）;萎缩组a波潜伏期与正常组相比,差异无统计学意义（P〉0.05）。③Ops振荡电位：萎缩组幅值较正常对照组显著下降（P〈0.05）。④P-VEP：萎缩组较正常组（空间频率34′）潜伏期显著延长（P〈0.05）,振幅显著下降（P〈0.05）。结论对于萎缩型黄斑变性患眼,眼电生理的变化早于OCT变化。这说明,年龄相关性萎缩型黄斑变性患者视功能改变早于视网膜神经上皮层的厚度改变,对于早期患者可优先选择电生理检查。     

Neural conduction in the visual pathways in ocular hypertension and glaucoma

Background: The aim of our work was to evaluate neural conduction in visual pathways in subjects with ocular hypertension and glaucoma. Methods: We assessed simultaneous recordings of pattern electroretinograms (PERG) and visual evoked potentials (VEP) in 16 subjects with ocular hypertension (OHT), in 16 subjects with primary open-angle glaucoma (POAG) and in 15 age-matched controls. The visual stimuli were checkerboard patterns (the check edges subtend 15 min of visual arc; contrast 70%) reversed at the rate of 2 reversals/s. Results: In OHT and POAG patients we found PERG and VEP latencies signficantly longer than in controls. The P50-N95 PERG amplitudes were significantly reduced in OHT and POAG eyes. VEP amplitudes were significantly reduced in POAG eyes, while in OHT they were similar to controls. The retinocortical time (RCT; difference between VEP P100 latency and PERG P50 latency) was longer in POAG patients than in controls; no differences between patients with OHT and controls were observed. Moreover, we observed that in POAG the longer RCT was inversely related to the PERG amplitude. Conclusion: Our results suggest that involvement of the innermost retinal layers in POAG is accompanied by slowed neural conduction in the visual pathways.Presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Fort Lauderdale, Florida, May 1995