视网膜色素变性患者的多焦视网膜电图与视网膜光学相干断层扫描的观察分析

目的研究视网膜色素变性(RP)患者的多焦视网膜电图(mERG)与视网膜光学相干断层扫描(OCT)的特性及图像特征。方法对已确诊的6例(12只眼)原发性视网膜色素变性患者和10例(20只眼)正常人的视网膜进行多焦视网膜电图与视网膜光学相干断层扫描检查,并对所得数据进行统计分析。结果RP患者视网膜黄斑中心凹厚度平均值低于正常人,但两者之间无显著差异性,RP患者OCT的视网膜断层反射像与正常反射像相比有较明显的改变;RP患者的多焦视网膜电图各环的反应密度均低于正常人,且有显著性差异,4~6环的潜伏期与正常人相比显著延长。结论多焦视网膜电图可有效地评价RP患者黄斑区及周边视网膜的功能,RP患者OCT的断层扫描像与其已知的视网膜病变特点相一致。     

视网膜色素变性的视网膜电图与光学相干断层扫描的观察分析

目的:观察视网膜色素变性(retinitis pigmentosa,RP)的全视野视网膜电图(global electroretinogram,ERG)、多焦视网膜电图(multifocal electroretinogram,mfERG)及视网膜光学相干断层扫描(optical coherence tomography,OCT)的图像特征及临床意义。方法:对临床确诊的RP患者组15例30眼和正常对照组15例30眼进行全视野ERG,mfERG与OCT检查,并对数据进行统计分析。结果:RP患者组全视野ERG显示b波潜伏期与正常对照组相比显著延长且b波振幅与正常对照组相比显著降低;mfERG各环的反应密度均低于正常对照组,且有显著性差异,3～5环的潜伏期与正常对照组相比显著延长。RP患者组OCT显示视网膜黄斑中心凹厚度平均值低于正常对照组,但二者比较,差异无统计学意义。结论:ERG可有效评价RP患者黄斑区及周边视网膜的功能,RP患者OCT断层扫描像与其已知的视网膜病变特点相一致。     

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。     

mfERG在原发性视网膜色素变性病程中应用研究

目的探讨多焦视网膜电图(multifocal elec-troretinogram,mfERG)一阶反应(first kernel response,FOK)P1波中振幅和潜伏期在原发性视网膜色素变性(retinitispig-mentosa,RP)病程中的应用研究。方法应用mfERG分别对RP患者44眼及正常人28眼进行FOK检测,将各环P1波的振幅和潜伏期进行比较,结果进行统计学分析。结果RP患者各环P1波的振幅反应密度值均低于正常组(P<0.001);第1环(37.17±3.15)ms至第4环(38.25±4.53)ms2组潜伏期相比无显著性差异(P>0.05),第5环(41.17±5.66)ms的潜伏期显著长于正常组(36.25±4.66)ms(P<0.001)。结论FOK主要反映的是视网膜外层的功能,具有立体、直观的特点,因而能客观评价和反映RP疾病对视网膜功能损害的程度。     

视网膜色素变性的多焦视网膜电图

目的研究视网膜色素变性（ＲＰ）的多焦视网膜电图（ＥＲＧ）特性和评价多焦ＥＲＧ应用价值。方法检测了 １２例（２４眼）ＲＰ患者的多焦 ＥＲＧ,测试野为２６．６°×２２．１°,记录 １０３个部位的反应,同时检测全视野 ＥＲＧ。结果ＲＰ眼在各个环的ａ波和ｂ波潜伏期、ｂ波振幅密度和振幅之和均较正常值有显著延长和降低（Ｐ＜０．０５或Ｐ＜０．０１）。５０％患眼在第１环可记录到潜伏期正常、振幅密度和总和均降低的ｂ波,而７５％患眼的全视野ＥＲＧ呈平坦反应。结论 多焦ＥＲＧ能更有效地评价ＲＰ的黄斑区功能。     

频域光学相干断层扫描在原发性视网膜色素变性中的应用

目的:应用频域光学相干断层扫描对原发性视网膜色素变性(retinitis pigmentosa,RP)患者进行图像分析,并评价其与视力敏感度的相关性。方法:对15例30眼RP患者和20例40眼正常人进行频域光学相干断层扫描,RP病例选择依靠病史、眼前后节检查、眼底荧光血管造影及电生理检查,所有病例均进行全层、内层及外层视网膜厚度的测量。正常组与RP组之间的视网膜厚度比较采用独立样本t检验,视网膜厚度与视力敏感度的相关性采用Pearson检验。结果:所有RP患者的光感受器层均变薄,正常组与RP患者的内层视网膜厚度变化无统计学意义,而全层及外层视网膜厚度变化有统计学意义。视力敏感度与全层视网膜厚度有较好的相关性,与外层视网膜厚度有更好的相关性。结论:应用频域光学相干断层扫描可以进行外层视网膜厚度的测量,而外层视网膜厚度可以对光感受器的丢失进行更好的评价,RP患者的外层视网膜厚度显著变薄,且与视力敏感度呈相关性。     

具有良好视敏度的视网膜色素变性患者多焦视网膜电图和OCT视网膜厚度之间的关系

目的采用光学相干断层扫描(optical coherence tomography,OCT)和多焦视网膜电图(multifocal electroretinography,mfERG),观察视网膜色素变性(retinitis pigmentosa,RP)患者视网膜形态和机能之间的关系。方法选取RP患者14例,视敏度≥0.2logMAR值,汉弗莱分析仪测定中心视野≥10     

视网膜色素变性的ERGs观察

目的：为研究视网膜色素变性的视网膜电图（ＥＲＧｓ）,测定了７５例１５０眼视网膜色素变性病人的ＥＲＧｓ,分析了其ｂ波振幅情况。方法：用视觉电生理仪测量ＥＲＧｓ的ｂ波振幅。分析从５个月到７０岁的７５例１５０多膜色素变性病人的ＥＲＧｓ的ｂ波振幅情况。结果：（１）ｂ波振重度降低或记录不到波形者１３０眼,占８７％,平均年龄２５岁,其最好视力达１．５,最低右无光感。（２）ｂ波振幅轻度或中度降低者１０例２０眼,     

视网膜色素变性疾病的OCT表现

视网膜色素变性（ｒｅｔｉｎｉｔｉｓｐｉｇｍｅｎｔｏｓａ,ＲＰ）是临床上常见的可致盲性眼病。近年来随着光学相干断层扫描等相关技术的发展,使直接观察ＲＰ患者的视网膜和脉络膜超微结构变化成为可能,其与ＲＰ患者的临床进展相关联。本文就近年ＲＰ患者的ＯＣＴ影像学表现研究进展进行综述。     

OCT及mfERG在DR早期及非增殖期中的应用

目的：用光学相干断层扫描（optical coherence tomo-graphy,OCT）测定糖尿病视网膜病变早期（non-diabetes retinopathy,NDR）及非增殖期（non-proliferative diabetes retinopathy,NPDR）的视网膜形态学改变及用多焦视网膜电图（multifocal electroretinogram,mfERG）测定其视网膜电活动的改变,评价不同分期糖尿病视网膜病变（diabetic retinopathy,DR）的严重程度。 方法：选取50~70岁的老年人30例30眼作为正常组,已确诊为2型糖尿病患者50例50眼做为实验组。分别在标准状态下行OCT及mfERG检查,并对结果进行统计学分析。 结果：对于NPDR的患者,视网膜形态的变化：视网膜黄斑区大部分神经上皮层变厚,说明对于糖尿病这个危险因素,视网膜的功能在不断的下降,视网膜黄斑区神经上皮层在NDR中变化并不明显而在NPDR明显变厚,说明黄斑区形态在糖尿病早期变化并不大,随着糖尿病的病情加重,形态发生了很大变化。电生理学改变：mfERG的P1波随着病情的加重,其反应密度逐渐下降,在NDR就明显减低,而在NPDR,下降更为明显,说明在黄斑区,视网膜形态改变前,电活动已经减弱,在形态发生变化后,电活动的下降更为明显。 结论：OCT联合mfERG测定黄斑区域的形态改变及电活动改变,两种检查手段在疾病的早期观察、随访和进一步治疗的选择上具有很高的应用价值。     

原发性视网膜色素变性的频域光学相干断层成像特征

目的观察原发性视网膜色素变性即色素性视网膜炎(retinitis pigmentosa,RP)的频域光学相干断层扫描检查(fourier-domain optical coherence tomography,FD-OCT)的图像特征。方法回顾性分析经临床确诊的30例60眼RP患者及30例60眼正常人FD-OCT检查资料,比较分析视网膜厚度及图像特征。结果正常组黄斑中心视网膜厚度为(174.6±14.9)μm;RP组黄斑中心视网膜厚度为(146.0±21.5)μm;RP组黄斑中心视网膜厚度较正常组降低,两组比较差异有统计学意义(t=3.487,P=0.001)。RP患者骨细胞样视网膜色素沉着区FD-OCT图像可见病变区色素上皮层光带断裂,与其相对应的神经上皮层可见增殖移行的色素上皮,黄斑区FD-OCT图像见光感受器内外节连接层反射部分或全部消失伴视网膜色素上皮层萎缩变薄。RP组中伴神经上皮层弥漫水肿5眼;黄斑囊样水肿3眼;黄斑前膜17眼。结论 FD-OCT可显示RP的组织病理改变,其影像学特征对临床诊断及病程估计有重要意义。     

近视患者黄斑区视网膜多焦视网膜电图和光学相干断层扫描的评估和分析

目的　使用多焦视网膜电图和光学相干断层扫描对近视患者黄斑区视网膜进行评估和分析。方法　符合入选条件的113例113眼，根据屈光度数和眼轴长度分为四组:正视组31例（31眼），等效球镜度数为+0.75~-0.50 D，且眼轴长度为22~24 mm；低中度近视组26例（26眼），等效球镜度数为>-0.50~-6.00 D，且眼轴长度为>24~26 mm；高度近视组34例（34眼），等效球镜度数为>-6.00~-10.00 D，且眼轴长度为>26~28 mm；超高度近视组22例（22眼），等效球镜度数>-10.00 D，且眼轴长度>28 mm。使用多焦视网膜电图和光学相干断层扫描对入选患者黄斑区视网膜功能和厚度进行测量。结果　随着近视程度的增加，各环P1波反应密度值逐渐减小，1环、2环、3环不同程度近视组间P1波反应密度差异均有统计学意义（均为P=0.00）。随着近视程度的增加，各环P1波振幅总和均逐渐减小，1～5环不同程度近视组间P1波振幅总和差异均有统计学意义（均为P=0.00）。随着近视程度的增加，P1波潜伏期逐渐延长，1环、2环、3环不同程度近视组间P1波潜伏期差异均有统计学意义（均为P=0.00）。随着近视程度的增加，黄斑中心凹视网膜厚度增加（P<0.001）。黄斑中心凹视网膜厚度与P1波反应密度呈负相关（r=-0.261，P=0.003），与P1波振幅总和呈负相关（r=-0.402，P<0.001），与P1波潜伏期呈正相关（r=0.340，P<0.001）。结论　随着近视程度的增加，黄斑中心凹视网膜厚度增加，视网膜功能下降。     

Longitudinal findings of acute macular neuroretinopathy with multifocal electroretinogram and optical coherence tomography

A 34-year-old woman, with preceding flu-like febrile illness, developed acute macular neuroretinopathy in her left eye with typical reddish brown macular lesions and a dense paracentral scotoma. Her condition was evaluated with multifocal electroretinogram and optical coherence tomography in her acute and recovery phases. The findings assist ophthalmologists striving for better understanding and diagnosis of acute macular neuroretinopathy.     

Analysis of spectral domain optical coherence tomography findings in occult macular dystrophy

Acta Ophthalmol. 2011: 89: e52–e56

Abstract.

Purpose: To describe findings of spectral domain optical coherence tomography (SD‐OCT) in the diagnosis of occult macular dystrophy (OMD). Materials and Methods: Five visually disturbed patients who had shown normal findings in full field electroretinogram (ERG), fundus photography and fluorescein angiography but abnormal findings in multifocal ERG had undergone SD‐OCT. The morphologic changes in retina and macular thickness were detected and imaged by SD‐OCT. We analysed the results of SD‐OCT including macular thickness, inner segment and outer segment (IS/OS) boundary and external limiting membrane (ELM). Results: Mean age was 41.6 (22–63) in three male and two female patients in this study. Mean central foveal thickness was 142.9 (76–161) μm. All patients had shown decreased bowing of IS/OS boundary, and five of nine eyes were noted with disrupted IS/OS boundary of the photoreceptors according to SD‐OCT. The interruption of external limiting membrane was noted in three of nine eyes. Conclusions: Spectral domain optical coherence tomography findings are useful in diagnosing OMD. Morphologic changes of the retina including deformity of the OS/IS boundary of the photoreceptors, disruption of the ELM and decreased foveal thickness may be important characteristics to consider when determining the pathophysiology and diagnosing criteria of OMD.     

Multifocal electroretinogram in non-pathological myopic subjects: correlation with optical coherence tomography

AIM: To investigate the changes of retinal function in non-pathological myopic subjects using multifocal electroretinography (mfERG) and to correlate the data with the central macular thickness obtained using optical coherence tomography (OCT). METHODS: One hundred and thirteen subjects (113 eyes) with age range from 18 to 35y were enrolled in the study. The subjects were divided into four groups according to spherical equivalent (SE) and axial length (AL): emmetropia group (EG, n=31; SE: +0.75 to -0.50 D; AL: 22 to 24 mm), low and medium myopia group (LMMG, n=26; SE: ＞-0.50 to -6.00 D; AL: ＞24 to 26 mm), high myopia group (HMG, n=34; SE: ＞-6.00 to -10.00 D; AL: ＞26 to 28 mm) and super high myopia group (SHMG, n=22; SE: ＞-10.00 D; AL:＞28 mm). The P1 amplitude density, P1 amplitude, and P1 implicit time of the first-order kernel mfERG responses were obtained and grouped into five rings. The central subfield macular thickness (CST) was obtained using macular cube 512×218 scan of Cirrus HD-OCT. RESULTS: With the increasing of eccentricity, the first positive peak (P1) amplitude density (P=0.0000, 0.0001, 0.0021 in ring 1-3 respectively) and P1 amplitude (all P=0.0000 in ring 1-5) of each group decreased. With the increasing of myopia, P1 implicit time gradually extended (all P=0.0000 in ring 1-3). The average CST in four diagnostic groups was 241.56±12.72 μm, 244.56±12.19 μm, 254.33±11.61 μm, 261.75±11.83 μm respectively. With the increasing of myopia, CST increased (P<0.001). There was negative relationship between CST and P1 amplitude, P1 amplitude density (r=-0.402, P<0.001; r=-0.261, P=0.003). There was positive relationship between CST and P1 implicit time (r=0.34, P<0.001). CONCLUSION: With the increasing of myopia, P1 amplitude density and P1 amplitude of the first-order reaction gradually reduced. This showed potential decline in retinal function in myopia. To some extent it may reflect the functional disorder or depression of the visual cells. The exact mechanism needs further study.