老年性黄斑变性的多焦视网膜电图改变

目的 测试并比较正常人和老年性黄斑变性患者的多焦视网膜电图。方法 应用美国EDI公司生产的VERIS science 4.0 视诱发反应图象系统对17例20只正常眼、7例10只老年性黄斑变性(age-related macular degeneration,AMD）干性型眼,8例　8只AMD湿性型眼和11例11只特发性黄斑裂孔(idiopathic macular hole,IMH)眼进行检测。将各组老年性黄斑变性者6个环形视网膜区域的N₁、P ₁波潜伏期和平均反应密度值与正常对照组进行比较。 结果 AMD湿性型各环N₁、P ₁ 波潜伏期和AMD干性型3～6环处N₁波潜伏期明显长于正常人。AMD湿性型在1～4环处N₁波和1～6环处P ₁波平均反应密度值下降,AMD干性型在1～5环处N₁波和1～6环处P ₁波平均反应密度值下降,IMH者在1～2环处N₁、1～3环处P ₁波平均反应密度值低于正常人。 结论 多焦视网膜电图可对老年视网膜穿孔黄斑变性部位进行视功能的定量检测。(中华眼底病杂志,2000,16:224-226)     

黄斑病变的多焦ERG特征

目的报告几种常见黄斑病变的多焦ERG特征.方法应用VERIS4.0视诱发反应图象系统检测黄斑裂孔、老年黄斑变性(干性型和湿性型)、中心性浆液性视网膜脉络膜病变、中心性渗出性视网膜脉络膜病变和Stargardt病于视网膜后极部26.6X22.1°内103个视网膜部位的反应曲线和立体功能图.结果;依据黄斑病变的病种和程度,反应曲线显示中心凹及黄斑区的反应降低或平坦,立体图显示峰值下降或凹陷.结论多焦ERG提供对黄斑病于黄斑区和后极部视网膜功能的定量和直观评价.     

早期老年性黄斑变性的暗视ERG检测

用暗视视网膜电图（ERG）检测了眼底有drusen的早期老年性黄斑变性（AMD）患者42例（56眼）和正常对照组50例（50眼）。结果与正常对照组相比，发现早期AMD有a波峰时和幅值异常。红光ERG的a波谷数减少（P＜0．005），而兰光ERG改变不显著（P＞0．05）。同时还发现，红光ERG的改变与视力、病变部位、类型有关．提示：暗视ERG可作为AMD早期的检测手段之一。     

老年黄斑变性的局部视网膜电图研究

目的:观察老年黄斑变性(AMD)对视网膜黄斑部电活动影响特征,并对局部视网膜电图(LERG)的敏感性作出评价。方法:对80例AMD患者99只眼进行了黄斑区三个范围局部视网膜电图(LERG)测定,并与患者的视力及相应检测范围病损面积进行了对比研究。结果:黄斑区2.5°、5°、7.5°范围内,干性AMD组LERG平均振幅降低,但与正常对照组间无显著性差异(P>0.05),湿性AMD组LERG平均振幅显著降低(P<0.01)。湿性AMD LERG b波振幅与病人视力呈正相关性,与相应范围病灶面积呈负相关。干性AMD玻璃膜疣数量对LERG尚无影响。结论:不同类型AMD对于黄斑功能损害程度不同,湿性型损害大于干性型;中心凹功能损害大于旁中心凹。LERG在AMD的黄斑功能测定方面是较敏感的电生理方法。眼科学报 1996;12:93—97。     

黄斑病变患者多焦视网膜电图的变化

目的:观察黄斑病变多焦视网膜电图穴mERG雪特点,探讨mERG在黄斑功能测定中的有效性。方法:应用德国罗兰视觉诱发反应成像系统,对黄斑病变71 眼与正常人48眼进行mERG测定,记录103个视网膜部位的一阶反应(first orderkernel,FOK)比较分析视网膜后极部不同区域a波和b波的平均反应密度值和潜伏期,并观察其三维图的改变。结果:黄斑病变患者1～3环a、b波平均反应密度下降,与正常值比较有显著差异。5、6环平均反应密度下降,无显著差异。1～6环a、b波平均潜伏期较正常组明显延长,三维图形上主要特征为中心凹及黄斑振幅明显降低,严重者反应呈平坦。结论:mERG能客观地对黄斑病变局部视网膜功能进行定量定位测定,是评价黄斑病变的一种有效客观检测手段,为疾病诊断和治疗效果客观的测定提供了一种有效方法。     

叶黄素和玉米黄质治疗年龄相关性黄斑变性的多焦视网膜电图变化观察

目的 应用多焦视网膜电图(multifocal electroretinography,mfERC)评价叶黄素(lutein)和玉米黄质(zeaxanthin)治疗年龄相关性黄斑变性(age-related macular degeneration,ARMD)的视网膜功能变化情况.方法 ARMD患者6例9只眼在接受叶黄素和玉米黄质治疗前及治疗后100d分别对各患眼5个环状视网膜区域进行b波反应密度的测量比较.记录以黄斑中心凹为中心呈同心圆排列的5个环区,自内至外分别是1环(2.18度),2环(7.46度),3环(12.36度),4环(19.66度)和5环(29.75度)的b波反应振幅密度,应用EPi Info统计软件中两个独立样本的t检验进行统计学分析.结果 9只眼ARMD患者治疗前后mf-ERG b波反应振幅密度比较,1,2,3,4,5环各环的振幅密度均明显提高,与治疗前相比差异具有统计学意义(P<0.05).结论 mf-ERG 显示叶黄素和玉米黄质治疗能有效提高ARMD患者mf-ERG的b波反应振幅密度,改善患眼视网膜光感受器功能.     

视网膜色素变性的多焦视网膜电图分析

测试并比较视网膜色素变性患者和正常人多焦视网膜电图。方法 :应用美国EDI公司生产的VERISScience 4 2多焦视网膜电图检查仪对 8例视网膜色素变性患者 8只眼 ,12例正常人 12只眼进行检测 ,分析其 6个环形视网膜区域的反应。结果 :视网膜色素变性患者 6个环形视网膜区域的反应密度均低于正常人 ,5环和 6环的潜伏期显著延长。结论 :视网膜色素变性患者多焦视网膜电图的反应密度下降 ,周边视网膜潜伏期延长 ,这种改变主要是由于视网膜感受器功能受损并且周边视网膜首先受累所致。     

正常眼和老年黄斑变性眼的局部视网膜电图

以全视野亮背景及４５′视角的红色闪光作刺激，采用带中孔的角膜接触镜电极，记录了局部视网膜电图。测得２２只正常眼的黄斑中心对盲点区的局部ＥＲＧ振幅之比值为３．５４±１．３５，而３１只老年黄斑变性眼的比值是１．３９±０．５４，两者差异显著（Ｐ＜０．０１），两组全视野明适应ＥＲＧ间无意义，表明此法建立的局部ＥＲＧ记录技术对早期老年黄斑变性病人具有一定诊断价值。     

黄斑病变的多焦视网膜电图分析

目的 测试并比较黄斑病变患者和正常人的多焦视网膜电图。了解视网膜功能。方法 用美国EDI公司的VERISscience4.2系统对6例6眼特发性黄斑裂孔（IMH），5例7眼中心性浆液性脉络膜视网膜病变（CSCR），5例8眼老年性黄斑变性（AMD，其中3例6眼干性型，2例2眼湿性型）眼，对6个环形视网膜区域反应的P1波反应密度和潜伏期进行Mann-Whitney检验。结果 所有黄斑病变患者1，2和3环的P1波反应密度下降，与正常对照组相比差异有显著性意义；潜伏期无明显异常。结论 多焦视网膜电图可对黄斑病变患者的视功能进行定量检测。     

Multifocal electroretinography in subjects with age-related macular degeneration

Purpose

To evaluate retinal function objectively in subjects with different stages of age-related macular degeneration (AMD) using multifocal electroretinography (mfERG) and compare it with age-matched control group.

Methods

A total of 42 subjects with AMD and 37 age-matched healthy control group aged over 55 years were included in this prospective study. mfERG test was performed to all subjects. Average values in concentric ring analysis in four rings (ring 1, from 0° to 5° of eccentricity relative to fixation; ring 2, from 5° to 10°; ring 3, from 10° to 15°; ring 4, over 15°) and in quadrant analysis (superior nasal quadrant, superior temporal quadrant, inferior nasal quadrant and inferior temporal quadrant) were recorded. Test results were evaluated by one-way ANOVA test and independent samples t test.

Results

In mfERG concentric ring analysis, N1 amplitude, P1 amplitude and N2 amplitude were found to be lower and N1 implicit time, P1 implicit time and N2 implicit time were found to be delayed in subjects with AMD compared to control group. In quadrant analysis, N1, P1 and N2 amplitude was lower in all quadrants, whereas N1 implicit time was normal and P1 and N2 implicit times were prolonged in subjects with AMD.

Conclusion

mfERG is a useful test in evaluating retinal function in subjects with AMD. AMD affects both photoreceptors and inner retinal function at late stages.     

Multifocal electroretinography (MF-ERG) in age-related macular degeneration

Purpose: Small areas of retinal pathology may pose diagnostic difficulties. The noninvasive multifocal electroretinogram (MF-ERG) provides a topographical mapping of retinal function. Its role in the diagnosis of macular diseases is examined in age-related macular degeneration (AMD). AMD is a main cause of central visual loss in the elderly population, affecting the second eye in 75 %. Methods: MF-ERG recordings of three patients with AMD were compared to the findings of fundus photography and fluorescein angiography. During the MF-ERG recordings the central 50 ° of the retina was stimulated. The visual stimulus consisted of 241 hexagons that alternated, independently and pseudorandomly, between black and white according to a special predetermined binary sequence. Local retinal response components were extracted using the Fast m-Transform Algorithm. Results: Three of six eyes had undergone cataract surgery with implantation of a posterior chamber lens (PCL). In accordance with an increase in light transmission through PCLs, these eyes showed an increase in the MF-ERG responses. MF-ERG allowed accurate topographic mapping of focal areas of retinal dysfunction in all patients tested. There was good correspondence to anatomical changes detected by fluorescein angiography. Conclusion: The high resolution of the MF-ERG enables detection of small areas of retinal pathology. It thus presents a clinically useful, noninvasive method in the early diagnosis and follow-up of macular disease.      

Morphological and functional retinal changes in neovascular age-related macular degeneration treated with intravitreal bevacizumab

Purpose:This study was conducted to determine the morphological and functional retinal changes in patients with neovascular age-related macular degeneration (nAMD) treated with intravitreal bevacizumab 1.25 mg.Methods:This was a prospective, nonrandomized, interventional study. Eighteen eyes of 18 subjects with nAMD were treated with intravitreal bevacizumab (1.25 mg) injection. Subjects underwent complete ophthalmic evaluation which included visual acuity, slitlamp examination, tonometry, binocular ophthalmoscopy, optical coherence tomography (OCT), and MP1 microperimetry before the intravitreal injection and the follow-up at 1 and 3 months. Test of significance such as Chi-squared test, paired ttest and oneway analysis of variance (ANOVA) linear trend were used to compare the pre- and post-anti-VEGF outcomes. Intraclass correlation was done to assess the intra observer variability.Results:Mean retinal sensitivity had increased from 3.77 ± 3.13 dB at baseline to 4.93 ± 2.42 dB at 3 months (P = 0.05). Visual acuity improved from 0.62 ± 0.36 at baseline to 0.52 ± 0.36 at 1 month and 0.48 ± 0.34 at 3-month followup, but overall change was not significant (P = 0.40). There was a significant reduction in central foveal thickness (CFT) from 274.61 ± 117.95 at baseline to 179.83 ± 84.18 at 1 month and 179.00 ± 126.55 at 3-month follow-up (P = 0.013).Conclusion:Intravitreal bevacizumab (1.25 mg) injection in nAMD improves retinal function, quantified by retinal sensitivity, scotoma characteristics, fixation stability by MP 1 microperimetry and morphological parameters quantified by CFT in SDOCT. These changes show the effectiveness of treatment with intravitreal bevacizumab in nAMD.     

A comparison of pattern and multifocal electroretinography in the evaluation of age-related macular degeneration and its treatment with photodynamic therapy

This study compares pattern electroretinography (PERG) and multifocal electroretinography (mfERG) measures in 13 patients with predominantly classic choroidal neovascularisation (CNV) associated with age-related macular degeneration (ARMD, 9/13 unilateral, 4/13 bilateral), assesses the usefulness of each test in monitoring disease progression, and identifies electrophysiological predictors of outcome following treatment with photodynamic therapy (PDT). PERG and mfERGs were recorded at presentation, 2 weeks post-treatment, and at 3 monthly intervals for 2 years. The PERG was detectable in 8/13 patients with unilateral disease; the mfERG was detectable in 12/13 patients. P50 and N95 amplitudes increased in 6/8 patients and mfERG p1 increased in 7/13 patients at 2 years. PERG amplitudes correlated strongly with mfERG amplitudes in patients with unilateral disease. PERG P50 and mfERG p1 amplitude correlated with visual acuity at 2 years (R = 0.68, R = 0.82, respectively). The largest PERG P50 and mfERG p1 amplitude difference between treated and fellow eyes of all the groups on initial visit was associated with a poor visual outcome (P50 64% difference; p1 29% difference) whereas those with the smallest P50 and p1 amplitude difference was associated with improved vision at 2 years (P50 30% difference; p1 21% difference). The PERG and mfERG provide an objective measure of central retinal function in the progression of ARMD. A detectable PERG on presentation was the single best indicator of improved function and visual acuity at 2 years. The mfERG demonstrated disease progression from central retina into the paramacular regions over 2 years. Patients with poor visual outcomes had the largest inter-ocular amplitude difference on presentation, suggesting that such patients may have a worse prognosis following treatment.In part presented at ARVO 2004 (Fort Lauderdale, USA) and ISCEV 2004 (Peurto Rico, USA).     

Multifocal electroretinography in patients with Stargardt's macular dystrophy

AIMS—To describe the topography of multifocal electroretinograms (ERGs) and to explore its diagnostic value in patients with Stargardt's macular dystrophy (SMD).
METHODS—51 patients with SMD were examined by means of the m-sequence technique to characterise the topography of electroretinographic responses in the central visual field. The results were compared with data from 30 normal volunteers.
RESULTS—In 49 of 51 patients with SMD, macular electroretinographic activity was markedly diminished or non-detectable. Towards more peripheral areas, ERG responses of the SMD patients approached those of normals. Implicit times were not markedly delayed at any eccentricity.
CONCLUSION—In contrast with Ganzfeld electroretinography, multifocal electroretinography is useful to detect foveal dysfunction in SMD. Areas of dysfunction were found to be usually larger than expected from psychophysical measurements and morphological alteration. In early stages of the disease it was possible to detect foveal dysfunction, even in patients lacking morphological fundus changes and with good visual acuity.

Keywords: Stargardt's macular dystrophy; fundus flavimaculatus; electroretinography     

经瞳孔温热疗法(TTT)治疗年龄相关黄斑变性的隐匿型黄斑部视网膜下新生血管膜的疗效观察

目的:探讨TTT激光治疗年龄相关的黄斑变性（ARMD）的隐匿型视网膜下新生血管膜的初步疗效。方法:15例15眼患ARMD隐匿型CNV的患者行TTT治疗,根据CNV的大小选择不同的光斑大小和能量,均照射一分钟。结果:15例患者术后FFA均显示渗漏减少或消失,眼底检查显示出血、渗出、水肿减轻,但15例患者视力均无明显改善。结论:TTT对治疗本组隐匿型ARMD的CNV是有效的而无害的,但需要更多的病例来评价治疗效果。