视网膜电流图振荡电位的计算机处理及临床应用

目的：研究视网电流图（electroretinogram,ERG)振荡电位（oscillatory potentials,OPs)的提取和分析方法及其临床应用。方法：测试了40只（40例）正常对照眼33只（33例）糖尿病视网膜病变（diaetic retinopathy,DR)患者、9只视网膜中央静脉阻塞（central retinal vein occlusion,CRVO)患者和9只视网膜分支静脉阻塞（branch retinal vein occlusion,BRVO)患眼的振荡电位,用快速傅里叶变换计算OPs的10－290Hz频谱,计算频谱的功率总和以及最大功率,通过快速傅里叶逆变换用110－250Hz频谱成分重构时域的OPs,测量重构的OPs4个子波的潜伏期、振幅和振幅总和。结果：与正常对照组比较,早期DR患眼140－210Hz振幅谱、功率总和以及最大功率下降,4个子波的太期延长,幅和振幅总和下降,CRVO患眼150－180Hz振幅谱、功率总和以及最大功率下降,BRVO患眼功率总和以及最大功率下降,第2和第3个子波的潜伏期延长,第1到第3个子波的振幅和振幅总和下降。结论：该文阐述OPs分析方法可为DR、CRVO和BRVO的诊断提供有效的客观指标。     

糖尿病视网膜病变的视网膜振荡电位

目的 研究振荡电位（ＯＰｓ）在糖尿病视网膜病变（ＤＲ）不同阶段的表现,探讨ＤＲ早期诊断的敏感性指标,并为ＤＲ国内分期提供功能学信息。方法 选择８３名糖尿病患者、１５５眼,进行眼底检查、眼底摄像;按国内ＤＲ分期将患眼分成眼底无改变、１期、２期、３期、４期但无玻璃体出血等５组,对所有患眼按国际标准化方法进行ＯＰｓ检测。选择４３只正常眼作对照。结果 ＯＰｓ总和振幅、ＯＰ２振幅在眼底无改变时下降,在１期时进一步下降;ＯＰ３振幅在１期时较对照下降,ＯＰ１振幅在２期对较对照和无改变组下降,ＯＰ４在３期时较对照下降,４期的ＯＰ２振幅以及３期和４期的ＯＰｓ总振幅分别与０期、１期和对照组的相应指标有差异。结论 ＯＰｓ和ＯＰ２振幅在ＤＲ临床前期下降,是ＤＲ早期诊断的敏感与客观性指标;ＯＰｓ及其子波振幅在ＤＲ早期和病变分期呈负相关,     

糖尿病视网膜病变的视网膜振荡电位

视网膜振荡电位 (OPs)是视网膜电流图的亚成分 ,在脊椎动物和人中 ,它通常由叠加在 b波上升相的 4～ 6个小波组成 ,它能敏感地反映视网膜的循环状态 ,是客观检测视网膜神经网络功能的记录方法。 OPs对许多视网膜疾病 ,如糖尿病视网膜病变 (DR)、视网膜静脉阻塞等的发病机制研究、诊断、随访、预后估计及疗效判断方面有重要作用 [1 ] 。1　视网膜振荡电位的起源195 3年 Cobb和 Morton首先在人眼记录到 b波上升相的一系列小波 ,后来被 Yunem ura于 196 2年命名为振荡电位 ,认为其有独特性 ,是视网膜电流图的独立成分。尽管至今已从海龟、…     

糖尿病视网膜振荡电位及图形视觉诱发电位联合应用研究

为了对糖尿病性视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＤＲ）早期发现,有效监测,阻止或降低致盲率,我们对正常人和糖尿病患者（ｄｉａｂｅｔｉｃｍｅｌｉｔｕｓ,ＤＭ）检测了图形视觉诱发电位（ｐａｔｅｒｎｖｉｓｕａｌｅｖｏｋｅｄｐｏｔｅｎｔｉａ...     

暗适应3.0振荡电位对视网膜中央静脉阻塞的临床应用

目的：探讨暗适应3.0振荡电位对视网膜中央静脉阻塞的临床应用价值。
　　方法：视网膜中央静脉阻塞患者84例84眼,初诊时行振荡电位检查,依据本实验室正常值进行分组,无波型(16例),重度降低型(27例),中度降低型(20例),轻度降低型(21例)。无波型与重度降低型拟诊缺血型视网膜中央静脉阻塞。轻度降低型与中度降低型拟诊非缺血型视网膜中央静脉阻塞。随访6mo,记录对比检查结果,共76例资料完整(8例失访)。
　　结果：重度降低型与无波型共34例(83%),最终诊断为缺血型视网膜中央静脉阻塞,中度降低型5例(25%)、轻度降低型0例最终诊断为缺血型视网膜中央静脉阻塞,三组比较具有统计学差异(χ2=34.5,P<0.01),其中重度降低型与轻度降低型以及中度降低型比较,具有统计学差异(P<0.01),轻度降低型与中度降低型比较,无统计学差异(P=0.036)。
　　结论：视网膜中央静脉阻塞早期的振荡电位振幅降低,振荡电位对视网膜中央静脉阻塞早期分型和预后评估有重要意义。     

早期糖尿病视网膜病变患者视网膜电图振荡电位和色觉检测

目的　探讨早期糖尿病视网膜病变 (diabetic retinopathy,DR)患者视网膜电图 (electroretinogram ,ERG)振荡电位 (oscillatory potentials,OPs)和色觉监测的指标。方法　尚无 DR改变 (DR0期 )的糖尿病患者和DR1期患者共 70例 (134眼 )分别用 Neuropack- 电生理仪测试 ERG OPs及用 FM- 10 0 Hue色相子排列法检查色觉 ,并与 30例 (5 9眼 )正常人的测试结果相比较。两种检查的测试结果亦作比较分析。结果　糖尿病组 OPs各小波潜伏期延长 ,振幅及各子波振幅总和下降 (P <0 .0 5 ) ,异常率为 40 .3%。除 OP3振幅外 ,DR1期组各波振幅及振幅总和低于 0期组 (P <0 .0 5 )。色觉异常率为 39.6 % ,轴向分析表明全部为蓝色觉异常 ,1期患者比 0期的平均错误分高 (P <0 .0 5 )。二者检查结果有良好一致性 (x2 =12 .1,P <0 .0 0 5 ) ,但检出率无显著差异 (x2 =0 ,P >0 .0 5 )。结论　 ERG OPs和色觉检查可作为评价患者视功能及 DR进展的指标 ,有利于对糖尿病患者进行跟踪随访及 DR的早期防治 ,具有一定的临床应用价值。     

糖尿病性视网膜病变视网膜电图振荡电位的频域和时域分析

为分析早期和晚期ＤＲ患者ＥＲＧ的ＯＰｓ频域和时域参数，为ＤＲ的早期诊断和估计预后提供客观指标。测定和比较了１７只Ⅰ～Ⅱ期ＤＲ患眼、４５只Ⅳ～Ⅴ期ＤＲ患眼和４０只正常对照眼的ＯＰｓ频域和时域参数。结果：Ⅰ～Ⅱ期和Ⅳ～Ⅴ期ＤＲ患眼与正常对照眼比较，部分平均频谱的幅度、总功率、最大振幅和最大功率均有显著下降；ＯＰｓ四个子波的潜伏期均显著延长，振幅均显著下降，四个子波振幅总和显著下降；主频率只在Ⅳ～Ⅴ期组显著下降。Ⅳ～Ⅴ期与Ⅰ～Ⅱ期ＤＲ患眼比较，部分平均频谱的幅度、最大振幅和最大功率有显著下降；ＯＰｓ前两个子波的潜伏期有显著延长，四个子波振幅及其振幅总和均有显著下降。结论：ＯＰｓ的频域和时域参数可作为评价ＤＲ不同病程和估计预后的客观指标。     

Analysis of Oscillatory Potentials of Flash Electroretinogram in Frequency Domain and Time Domain in Retinal Vein Occlusion

Purpose: To analyse the parameters of frequency domain and time domain of the OPs in branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Methods : OPs from 9 eyes of BRVO, 9 eyes of CRVO and 40 normal control eyes were tested . The frequency spectra of the OPs were derived through Fast Fourier Transform (FFT) . The mean frequency spectra, the total power, the maximum magnitude, the maximum power and the dominant frequency in frequency domain of the OPs from the eyes of BRVO, CRVO and the normal control group were compared with each other. The OPs waveforms were reconstructed with the OPs frequency spectra data by counter-FFT. In time domain, the latencies, the amplitudes and the sum of the amplitudes of the four wavelets of OPs were measured and compared in the above subjects.Results: There were no statistically significant differences in the magnitudes of frequency spectra, the total power, the maximum magnitude and the maximum power in the frequency range from 110 to 250 Hz     

Measuring oscillatory potentials: Fourier analysis

Studying the oscillatory potentials in diabetic retinopathy, the authors experienced several problems interpreting results of digital filtering. The main problem was the separation of the first potential from the a-wave, since their frequencies are within the same range. To improve the procedure of measuring implicit times and of calculating amplitudes, the filtering was started with a finite impulse response filter and followed by a fast Fourier transform. The power of the oscillatory potential was calculated by determining the dominant frequency in the Fourier transformed response and expressed in microwatts. A group of normal subjects was compared with a group of early diabetic retinopathy patients. It appears that even in pathological circumstances a quantitative expression of the oscillatory potential is possible.     

Electroretinographic oscillatory potentials in diabetic retinopathy

The oscillatory potentials of the electroretinogram in dark and light adaptation were evaluated by Fourier transform in 87 diabetics and 74 age-matched controls. The study consisted of four groups: normal control, no observable diabetic retinopathy, background diabetic retinopathy and proliferative diabetic retinopathy. A reduction in the amplitude of each oscillatory potential, the summed amplitudes, the area and the total power of the oscillatory potentials as well as delayed implicit time of each oscillatory potential peak in dark and light adaptation could be found in patients with background diabetic retinopathy and proliferative diabetic retinopathy. The amplitude of oscillatory potential 4 in dark adaptation and the total power of the oscillatory potentials in light adaptation seemed to be affected in patients with no observable diabetic retinopathy. The implicit time of oscillatory potential 2 in dark adaptation was valuable to distinguish between patients with no observable diabetic retinopathy and background diabetic retinopathy.Abbreviations NC normal control - NDR no observable diabetic retinopathy - BDR background diabetic retinopathy - PDR proliferative diabetic retinopathy     

视网膜振荡电位和视觉诱发电位检测在糖尿病视网膜病变前期诊断中应用

目的:观察尚未发生眼底病变的糖尿病确诊患者在不同病程时期视网膜振荡电位(OPs)和视觉诱发电位(VEP)的变化情况。方法:采用国际标准法对35例70眼正常人进行OPs和VEP的检测,对94例188眼未发生眼底病变糖尿病确诊患者按病程长短分为3组,分别进行OPs和VEP的检测。结果:各实验组与对照组相比表现为OPs幅值的降低和VEP峰值降低,潜时值延长,P<0.01,有显著统计学差异。各实验组之间相比表现为病程越长OPs幅值越低和VEP峰值越低,潜时值越长,P<0.01,有显著统计学差异。结论:糖尿病患者在眼底尚无病变前,其OPs和VEP已经出现异常,并且随着糖尿病病程的延长,各项指标的变化更加明显。因此,采用OPs和VEP的联合检测可以为糖尿病视网膜病的早期诊断提供依据。     

Basic research and clinical aspects of the oscillatory potentials of the electroretinogram

This paper reviews current knowledge concerning the oscillatory potentials (OPs) of the electroretinogram (ERG). The first section describes the basic characteristics of the OPs primarily studied in healthy subjects. The behavior of the OPs is different from the a- and b-waves, indicating separate mechanisms for generation of the OPs compared with the major components of the ERG. The second section deals with the present view of the origin of the OPs collected from experimental studies of the vertebrate retina, including the primate. Findings favor the conclusion that the bipolar (or interplexiform) cells are the probable generators of the OPs. The third section gives clinical examples of the sensitivity of OPs to early disturbances of retinal function in different eye diseases.     

糖尿病视网膜病变振荡电位和荧光血管造影的相关性

目的 :研究在荧光素钠血管造影 (FA)和吲哚青绿血管造影 (ICGA)下糖尿病视网膜病变 (DR)在不同阶段、形态改变时的振荡电位 (OPs) ,了解DR的功能学与形态学改变的特点及其之间的联系。方法 :选择 4 9名糖尿病患者(89只患眼 ) ,按在FA下DR的不同阶段分 4组 (88眼 ) ,按ICGA分 2组 (6 0眼 ) ,选择 4 3只正常眼为对照组 ,对所有眼按国际标准化方法进行OPs检测。结果 :OPs总和振幅在FA有改变时下降 ,OP2 振幅在FA无改变时下降 ,有改变时进一步下降 ;无灌注期与新生血管期的OPs总和振幅及各子波振幅改变相同 ;ICGA晚期 ,部分眼出现晚期弥散性高荧斑和极晚期高荧伴低荧的“椒盐状”外观 ,与此相应 ,OP3 振幅和OP4潜伏期较对照组下降和延长。结论 :OP2 振幅较OPs总和振幅在DR早期诊断方面敏感 ,无灌注期和新生血管期的视网膜循环状态相似 ,无灌注区可与新生血管一样作为DR进展的质变标志 ,ICGA后期改变与OPs的指标有一定联系     

视网膜脱离复位后的振荡电位观察

目的：应用视觉电生理技术观察孔源性视网膜脱离复位术后的振荡电位变化，了解术后视网膜的微循环改善情况。方法：选用美国LKC公司UTAS－E2000型电生理仪，按照国际标准化建议对73例孔源性视网膜脱离患者在巩膜扣带术术前，术后记录振荡电位，术后随访个月。选择43例为对照组。结果：视网膜脱离后，振荡电位振幅明显下降，子波数减少，手术复位后1个月，子波数增加，但振荡电位的总振幅在随访期间无明显变化，仅在术后5个月有缓慢增长趋势。一些病例可在术后远期出现改变。结论：视网膜脱离复位后，其微循环在短期内有一定程度的恢复，与手术方法及视网膜的病理损害有关。