视网膜电图明视负向反应在视网膜静脉阻塞中的变化

目的 观察视网膜静脉阻塞(RVO)患者视网膜电图(ERG)明视负向反应(PhNR)的变化特点.方法 对间接检眼镜、荧光素眼底血管造影(FFA)检查确诊的RVO患者30例30只患眼以及对侧健康眼进行视力、视野、闪光ERG(FERG)检查,同时选取与其性别、年龄相匹配的正常人25例50只眼作为正常组进行FERG检查.所有检查均按常规方法进行.RVO患者中,视网膜中央静脉阻塞(CRVO)患者14例14只眼、视网膜分支静脉阻塞(BRVO)患者16例16只眼.根据其病史及FFA检查结果,将其按病程时间划分为小于1个月、1～3个月、大于3个月组;另外再根据RVO分型标准及具体检查结果,将RVO患者分为缺血型和非缺血型.对比分析RVO患眼与对侧健康眼以及正常眼PhNR振幅变化及ERG其他参数指标,包括振荡电位(Ops),视锥细胞反应(Cone-a、Cone-b),视杆细胞反应(Rod-b),暗适应眼的最大反应(Max-a、Max-b),30 Hz闪烁光反应(30 Hz)的差异以及PhNR振幅变化与RVO疾病缺血类型、病程的关系.结果 PhNR振幅在CRVO患眼为(28.20±5.80)μV,BRVO患眼为(36.96±4.71)μV,对侧健眼为(61.25±3.93)μV,正常眼为(59.33±16.92)μV.CRVO组与对侧健眼、正常组比较,差异有统计学意义(F=10.69,9.80;P＜0.001),BRVO组与对侧健眼、正常组比较,差异有统计学意义(F=9.69,9.75;P＜0.001).CRVO组中缺血型PhNR值为(22.77±5.73)μV,非缺血型为(36.63±12.91)μV,二者差异有统计学意义(t=6.54,P＜0.01);BRVO组缺血型PhNR值为(32.39±13.22)μV,非缺血型为(46.73±10.43)μV,二者差异无统计学意义(t=2.12,P＜0.05);病程小于1个月组CRVO与BRVO分别为(24.58±4.60)、(27.94±15.73)μV,1～3个月组分别为(50.39±13.80)、(58.69±12.43)μV,大于3个月组为(25.40±19.94)、(34.48±16.72)μV,CRVO中1～3个月组与大于3个月组差异有统计学意义(F=4.30,P＜0.01).结论 RVO患眼的PhNR振幅较对侧健康眼以及正常对照眼明显降低,缺血型较非缺血型降低,随病程变化呈现下降、上升、下降的变化趋势.

Changes of photopic negative response in retinal vein occlusion

Objective To observe the changes of photopic negative response (PhNR) of electroretinography (ERG) in patients with retinal vein occlusion (RVO).Methods A total of 30 patients (30 eyes) with retinal vein occlusion (RVO) diagnosed by indirect ophthalmoscopy and fundus fluorescein angiography (FFA) were selected;the unaffected fellow eyes of the patients and another 25 healthy agematched individuals (50 eyes) were cllected as the normal control.All of the patients underwent the examination of visual acuity,visual field,and flash-ERG (FERG);the normal control ones underwent FERG.In the 30 patients with RVO,there were 14 with central RVO (CRVO) and 16 with branch RVO (BRVO).According to the disease history and results of FFA,the patients were divided into 3 time groups:＜1 month,1-3 months,and＞3 months;according to the types of RVO,the patients were divided into ischemic and non-ischemic group.The amplitude of PhNR and other parameters were analysed.The relationship among the amplitude of PhNR and RVO types and time course were analyzed.Results The amplitude of PhNR in the CRVO and BRVO eyes was (28.20±5.8) and (36.96±4.71) μV,respectively;those in the unaffected fellow and control eyes was (61.25±3.93) and (59.33±16.92) μV,respectively;the amplitude of PhNR was significantly smaller in the CRVO and BRVO eyes than those in the unaffected fellow or control eyes (F=10.69 and 9.80,P＜0.001;F=9.69 and 9.75,P＜0.001).The amplitude of PhNR in ischemic and non-ischemic group in CRVO eyes was (22.77±15.73) and (36.63±12.91)μV,respectively;the difference between the two groups was significant(t=6.54,P＜0.01).The amplitude of PhNR in ischemic and non-ischemic group in BRVO eyes was (32.39±13.22) and (46.73±10.43)μV,respectively;there was no significant difference between the two groups (t=2.12,P＜0.05).The amplitude of PhNR was (24.58±14.60) and (27.94±15.73)μV,respectively,in CRVO and BRVO eyes with＜1 month disease course;was (50.39±13.80) and (58.69±12.43)μV in those with 1-3 months disease course;and was (25.40±19.94) and (34.48±16.72)μV in those with＞3 months diseases course.Significant difference was found between the 1-3 months group and＞3 months group in CRVO eyes (F=4.30,P＜0.01).Conclusions The amplitude of PhNRs was significantly smaller in RVO eyes than those in the unaffected fellow or control eyes .The amplitude of PhNR amplitude of ischemic type was smaller than that of non-ischemic type.The amplitude of PhNR has descending,ascending,and descending tendency during the disease courses.