挫伤眼球视功能的电生理评价

目的：研究挫伤眼球的多焦视网膜电图（MERG）改变，探讨多焦电生理检查在眼球挫伤中的应用价值。方法：视网膜挫伤患者44例47眼，应用国产多焦电生理系统国特GT2000NV进行MERG检查，对伤眼与正常眼的总体参数及各环的振幅和潜伏期进行比较。结果：受伤眼的矫正视力与中心凹区一环的b波振幅密度之间具有线性正相关关系：伤眼与正常眼之间多焦视网膜电图的a波及b波的潜伏期及一环b波振幅密度值的差异具有显著性。结论：国产多焦电生理系统能够客观反映挫伤眼球的视功能损害程度，是评价眼球挫伤患者视功能的客观有效工具。     

干性年龄相关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(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)正常人应用稳态的闪烁光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。     

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。     

实验性眼冲击伤视网膜电图的改变

实验性兔眼冲击伤后，视网膜电图（ERG）a、b波振幅明显降低，分别约为伤前35%及54%，并于伤后14d，21d才恢复至伤前水平。地塞米松合并蝮蛇抗栓酶治疗组ERG a、b波振幅恢复早于对照组及地塞米松合并妥拉苏林或单纯用地塞米松的两个治疗组。表现一定能量的冲击波可造成明显的视网膜功能损害，ERG可作为检测损伤程度，客观评价疗效的重要指标。 （中华眼底病杂志，1995，11：169-171）     

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(central retinal vein occlusion,CRVO)患者进行视网膜电图(electroretinogram,ERG)的检测．缺血型CRVO13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。 （中华眼底病杂志，1994，10：7-10）     

正常眼多焦视网膜电图特征的初步探讨

目的 :初步分析正常人眼多焦视网膜电图 (m ERG)测量值 ,并探讨正常眼视网膜后极部不同部位的电生理功能。方法 :对 19例 (2 5眼 )散瞳正常眼作多焦视网膜电图检查 ,记录 6 1个部位反应波形图 ,分析视网膜后极部不同区域的a波 (第 1个负波 )和b波 (第 1个正波 )的潜伏期、振幅值及振幅密度。结果 :视网膜后极部中心环 (第 1环 )振幅密度为最高 ,a波为 (33.92± 18.95 )nV/deg2 ,b波为 (6 8.78±19.84 )nV/deg2 ,随着离心度的增加 ,各振幅密度逐渐下降 ,差异有显著性 (P <0 .0 1)。a波及b波潜伏期、振幅及振幅密度在四个象限的差异均无显著性 (P >0 .0 5 )。结论 :多焦视网膜电图能客观、定位、定量地测定视网膜后极部不同部位的视功能 ,其测定的正常值为临床研究提供了参考数值     

眼底无可见视网膜病变的糖尿病患者多焦视网膜电图特征

目的 检测眼底无视网膜病变糖尿病患者的多焦视网膜电图(multifocol electmretinogram, mf-ERG),评价其在糖尿病患者早期视网膜功能改变中的作用.方法 应用mf-ERG检测30例(56只眼)正常对照组和32名(58只眼)无眼底镜下可查见的视网膜病变的糖尿病患者.对两组mf-ERG中a波和b波的潜伏期、振幅总和以及b波的振幅密度进行分析比较.结果 在糖尿病组,除0环和颞下象限之外.b波的潜伏期均明显延迟,而a波和b波振幅总和及b波的振幅密度减低主要集中在黄斑周围区域(0～1环)和颞上象限,差别有统计学意义(P<0.05).结论 mf-ERG能在DR出现之前客观定量地评定视网膜功能的变化程度和范围.     

早产儿视网膜功能的全视野闪光视网膜电图检查

目的 观察早产儿视网膜功能变化特征。方法 对78例4～5个月婴儿在口服镇静 剂熟睡后进行全视野闪光视网膜电图（ERG)检查，测量各项反应的a波和b波的振幅和隐含期 ，以评价未成熟儿的视网膜功能。78例156只眼中，健康足月产儿33例66只眼，健康早产儿2 5例50只眼，早产儿视网膜病变（ROP）患儿20例40只眼。结果 所有足 月产儿和健康早产儿 都可以记录到明显的ERG波形。足月产儿的标准混合反应b波振幅为388.7 μV，健康早产儿 的标准混合反应b波振幅为336.7 μV，分别为正常成人混合反应b波振幅的64.4％和55.6 ％。ROP患儿中，20只眼记录不到波形，其余20只眼的标准混合反应b波振幅为183.8 μV，和足月产儿相比，隐含期也显著延迟。健康早产儿的ERG振幅较足月产儿 轻度降低， 差异有统计学意义。结论 出生后视网膜还处于不断成熟发育过程中， 健康足月产儿的ER G尚未达到正常成人的水平；早产儿视网膜发育程度较足月儿慢，不论是健康早产儿还是ROP 患儿，其ERG均不及健康足月产儿。因此ERG检查是评价早产儿视网膜功能的有效方法。     

伴视网膜脱离的高度近视眼m-ERG和传统视觉电生理改变

目的 观察高度近视患者视网膜脱离术前的视觉电生理改变，了解视功能损害程度。方法 回顾我院住院手术的高度近视患者视网膜脱离29例，与对侧高度近视眼、正常人48只眼对照组进行A／B超、传统视觉电生理F—ERG、F—VEP、多焦视网膜电图(一阶反应，first orderkernel，FOK)联合检测。结果 高度近视患者视网膜脱离眼轴比正常对照组眼眼轴长；F—ERG表现为振幅下降明显，同时潜伏期下降，甚至呈熄灭型，F—VEP P100改变无明显差异。m—ERG高度近视视网膜脱离眼及对侧眼中心凹振幅密度下降，a、b波振幅下降，但对侧高度近视眼潜伏期无改变。结论 联合应用A／B超、传统视觉电生理、多焦视网膜电图，为观察其眼轴变化，视功能受损提供了敏感客观依据，能定量、定性评价黄斑部后极部视网膜、视神经功能。     

中心性浆液性视网膜脉络膜病变的多焦视网膜电图特征

目的 探讨中心性浆液性视网膜脉络膜病变(CSC)的多焦视网膜电图(mERG)特征。方法 对18例(18眼)CSC患者的患眼和对侧眼做多焦视网膜电图检查，记录61个部位反应，比较分析视网膜后极部不同区域的a波(第1个负波)和b波(第1个正波)平均反应振幅密度。结果 CSC眼组1～3环a波和b波平均反应振幅密度明显低于正常对照组，两者之间差异有显著性意义。结论 多焦视网膜电图能对CSC局部视功能进行定量定位测定，为疾病诊断和治疗效果监测提供重要手段。     

Retinal function in diabetic macular edema after focal laser photocoagulation

PURPOSE: To assess the effects of focal photocoagulation on retinal function in the macular and perimacular areas in patients with diabetes who have clinically significant macular edema. METHODS: Eleven patients were assessed after focal laser treatment. Multifocal electroretinogram (ERG) and full-field ERG techniques were used to evaluate the effects of treatment on macular, paramacular, and peripheral retinal function. A modified visual field technique was used to obtain local threshold fields. The posttreatment results were compared with pretreatment results. Changes in local ERG response amplitudes and implicit times were calculated for each patient and presented as difference fields. The changes in local ERG responses were compared with the changes in local field sensitivity. RESULTS: After treatment, the results of the psychophysical tests suggested little or no change in visual function, but changes in retinal function were observed with the multifocal ERG technique. Local ERG responses showed increases in implicit time and decreases in amplitude, compared with pretreatment values. Timing was affected more than amplitude. CONCLUSIONS: The results suggest that focal treatment produces changes in retinal function, and these changes are not restricted to the treated macular area.     

The Role of mf-ERG in the Diagnosis and Treatment of Age-Related Macular Degeneration: Electrophysiological Features of AMD

Introduction: Age-related macular cegeneration (AMD) is the leading cause of visual dysfunction worldwide, affecting 9–25% of individuals between 65 and 75 years old. Methods: We have reviewed the published articles investigating the role of multifocal electroretinogram (mf-ERG) in the diagnosis and treatment of AMD. Results: Visual evoked potentials have revealed decreased amplitudes and higher latencies in patients with AMD, while the degeneration of photoreceptors and abnormalities of retinal pigment epithelium can be identified by electro-oculogram recordings. Moreover, ERG can detect the functional abnormalities observed in AMD and evaluate each therapeutic approach. The record of local electrophysiological responses coming from different retinal areas can be accurately performed by mfERG. Conclusion: The accuracy of mfERG in detecting the degeneration of photoreceptors, as well the disturbances of macular function, could be useful both in the early diagnosis of AMD and the assessment of treatment efficacy.     

Foveal electroretinograms and choroidal perfusion characteristics in fellow eyes of patients with unilateral neovascular age-related macular degeneration.

AIMS/BACKGROUND--A prolonged choroidal filling phase on fluorescein angiography has been reported to be a common finding and associated with visual function abnormalities in patients with age-related macular degeneration (AMD). This investigation was carried out to determine whether this perfusion defect was related to the slowing of foveal cone electroretinogram (ERG) implicit time seen in patients with AMD. METHODS--Fluorescein angiograms and foveal cone ERGs were evaluated in the fellow eyes of 67 patients with unilateral neovascular AMD. RESULTS--Twenty eight (42%) of the eyes had a choroidal perfusion defect. ERG implicit times averaged 1 ms slower (p = 0.0167) and were more likely to be delayed (p = 0.0078) in eyes with abnormal choroidal perfusion than in eyes with normal choroidal filling; significant relations were found also after controlling for age. ERG implicit time was also inversely related to ETDRS visual acuity and positively related to the extent of macular drusen; and the latter showed a borderline significant tendency to be more prevalent in eyes with prolonged choroidal perfusion. However, an association of a delayed ERG implicit time with prolonged choroidal filling remained after controlling for age, acuity, and the extent of drusen. CONCLUSION--These findings further establish prolonged choroidal perfusion as a common finding in AMD and link it to retinal malfunction.     

The nature and extent of retinal dysfunction associated with diabetic macular edema

PURPOSE: To evaluate the nature and extent of retinal dysfunction in the macular and surrounding areas that occurs in patients with diabetes with clinically significant macular edema (CSME). METHODS: Eleven patients were evaluated before focal laser treatment. Multifocal electroretinogram (ERG) and full-field ERG techniques were used to assess the effects of diabetic retinopathy and CSME on macular, paramacular, and peripheral retinal function. A modified visual field technique was used to obtain local threshold fields. The relationship between local sensitivity changes and local ERG changes was determined. RESULTS: Local ERG responses were significantly delayed and decreased in amplitude, and timing changes were observed in a larger area of the retina than amplitude changes. Visual field deficits were similarly widespread with marked sensitivity losses occurring in retinal areas with normal ERG amplitudes and in areas that appeared to be free of fundus abnormalities. Despite this similarity and the finding that retinal areas with elevated thresholds have timing delays, timing delays were not good predictors of the degree of threshold elevation. CONCLUSIONS: The results demonstrate the widespread nature of timing deficits and visual field deficits that are associated with CSME.     

Deficits in the electroretinogram in neovascular age-related macular degeneration and changes during photodynamic therapy

Purpose To describe the deficits in four electroretinography (ERG) modalities in patients with neovascular age-related macular degeneration (AMD). To describe the changes in these parameters during a course of verteporfin photodynamic therapy (PDT). Methods Pattern (PERG), multifocal (mfERG) (19 segment simplified test protocol), flash ERG and flicker ERG were performed in patients with active neovascular AMD before PDT and compared to fellow eye controls using paired t-tests. Changes in ERG parameters during the 12 month treatment course were visualised using 95% confidence intervals of the median difference. The statistical significance of any changes was quantified using Wilcoxon signed ranks tests. Results Fifty patients were recruited and followed. At presentation all ERG amplitudes were reduced with greater reductions in focal as opposed to global test protocols (P < 0.05). Over the 12 month course of PDT, PERG P50 amplitude showed a general downward trend and latency remained unchanged. mfERG p1 amplitude density showed an upward trend at six months before returning to baseline by 12 months. mfERG ring 2 amplitude density was significantly increased at 12 months compared to baseline (P = 0.010). Flicker ERG latency was significantly increased at six months compared to baseline (P = 0.015). Discussion The simplified mfERG protocol was tolerated by this patient group, however, they found the full test protocol demanding. Large deficits in the retinal ERG function occur in neovascular AMD and involve retinal locations adjacent to as well as overlying choroidal neovascularisation (CNV). After PDT there is an improvement in electro-retinal function in retinal locations overlying the CNV.     

视网膜中央静脉阻塞性黄斑水肿的OCT与ERG的对比分析

目的：观察视网膜中央静脉阻塞性黄斑水肿的黄斑区视网膜厚度与视网膜电图( electroretinogram, ERG )各项参数(Cone-a,Cone-b和30Hz)变化的关系。
　　方法：随机选择视网膜中央静脉阻塞患者25例25眼及25只对侧眼分别行明视闪光视网膜电图及光学相干断层扫描( optical coherence tomography,OCT)检查,明视闪光视网膜电图检查测各项参数的振幅和潜伏期, OCT测量黄斑区九部分的视网膜厚度,分析黄斑区形态参数与明视闪光视网膜电图各参数变化之间的关系。
　　结果：黄斑区除颞侧外七个部位视网膜厚度与 ERG 的Cone-b和30 Hz潜伏期相关。
　　结论：研究发现视网膜中央静脉阻塞患者的黄斑区视网膜厚度与内层视网膜功能密切相关。     

Testing central retinal function with multifocal electroretinography before and after photodynamic therapy

BACKGROUND: Photodynamic therapy (PDT) is applied for certain forms of choroidal neovascular membrane (CNV). The aim of this study was to investigate the effect of PDT on central retinal function as assessed by multifocal electroretinography (ERG). METHODS: 24 patients (25 eyes) with CNV (>50% classic 12 eyes) or occult (9 eyes) in age related macular degeneration (AMD) and CNV with pathological myopia (4 eyes) were treated by PDT using Verteporfin((R)). Before and a median of 6 weeks after therapy, central retinal function was examined using multifocal ERG (RetiScan, 61 hexagons, first-order response). RESULTS: In the area of treatment,we found a tendency of the amplitude of the first positive deflection (P1) to decrease and of the implicit time to increase, but both effects were not statistically significant. These alterations were more pronounced in eyes with occult CNV and in myopia-related CNV. Amplitude reduction and implicit time prolongation could also be found in the areas represented by the multifocal ERG but not treated. There was no significant correlation between change in visual acuity after PDT and amplitude of the multifocal ERG. CONCLUSION: The effects of PDT on retinal function seem to be moderate as assessed by multifocal ERG. An inherent problem of this investigation was the recruitment of nontreated patients as controls. Future goals are investigations of patients with repeated PDT and of long-term alterations in multifocal ERG after PDT.     

自体带Bruch膜视网膜色素上皮复合体移植治疗渗出性老年黄斑变性近期疗效观察

目的 探讨自体带Bruch膜视网膜色素上皮复合体移植术治疗渗出性老年性黄斑变性近期疗效.方法 回顾性分析30例确诊为渗出性老年性黄斑变性的患者,采用脉络膜新生血管膜切除联合自体带Bruch膜视网膜色素上皮复合体移植手术方法.手术前后行视力、荧光素眼底血管造影、吲哚氰绿眼底血管造影、多焦视网膜电图、光学相干断层扫描检查评价疗效.结果 移植术后随访6个月时,25例(83.33%)患者视力获得提高,2例(6.66%)患者视力不变,3例(10%)患者视力下降;所有患者黄斑区RPE植片平铺在位,未见CNV复发.结论 自体带Bruch膜视网膜色素上皮复合体移植治疗渗出性老年性黄斑变性近期疗效确切,是治疗渗出性老年性黄斑变性安全有效的手段之一.