视网膜电图对预测白内障术后视力的意义

目的探讨视网膜电图(ERG)对预测白内障术后视力的意义。方法对148例(176眼)白内障术前行ERG检查,以暗适应白光b波振幅和30Hz内烁光振幅为主要观察指标,比较术后不同视力组与对照组之间振幅的差异。根据术后不同视力分A,B,C3组,各组视力依次为0.1~0.2,0.3~0.5和大于0.5。结果C组患者术前ERG-b波及30Hz振幅接近正常对照组,B组和A组的振幅均有不同程度的降低,与正常对照组间差异有统计学意义(P<0.01)。结论术前暗适应白光ERG-b波振幅和ERG-30Hz的振幅与白内障术后视力密切相关,其中30Hz振幅更有意义。     

蓝光ERG预测白内障术后视功能的临床观察

目的　应用蓝光视网膜电流图 (蓝光 F- ERG)预测白内障术后视功能。方法　术前采用暗适应蓝、白光 (比标准闪光衰减 2 .5 log单位的低强度光 )视网膜电流图分别检查拟行白内障手术眼 ,将术后 3月最佳矫正视力、周边 (黄斑中心凹 10°以外 )视网膜状况与术前两种 F- ERG b波振幅分别作对比分析。结果　术前蓝光 F- ERGb波振幅与白内障术后 3月最佳矫正视力轻度正相关 (相关系数 r =0 .2 6 76 ,F =4.86 ,P =0 .0 32 3) ,蓝光 F- ERGb波振幅与白内障术后周边视网膜状况呈高度正相关 (相关系数τ =0 .2 439,x2 =12 .6 5 47,P <0 .0 0 0 1) ,其相关性大于白光 F- ERG(相关系数τ =0 .16 0 0 ,x2 =4.7717,0 .0 1

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钝挫伤性脉络膜视网膜病变的视网膜电图分析

目的：利用视网膜电图（ERG）评价挫伤性脉络膜视网膜病变的损伤程度与皮质类固醇治疗效果。方法：回顾分析250例单眼钝挫伤性脉络膜视网膜病变的EGR资料。以伤眼视力分为＜0．01、0．1～0．5和＞0．53组。结果：暗适应ERGb波波幅是3组之间差异显著的指标。26例经大剂量皮质类固醇治疗2周，69．2％视力明显提高，ERGb波波幅回升。结论：暗适应ERGb波波幅对估计视力预后有重要价值，大剂量皮质类固醇对视力恢复有一定效果。     

红光ERGx波预测白内障术后视力的应用

目的应用视觉电生理诊断技术预测白内障术后视力.方法采用标准暗适应红光视网膜电流图(红光F-ERG)分别检查拟行白内障手术眼与正常同龄对照(无白内障)组,比较两者的暗适应红光ERGx波检出率、x波振幅,并将白内障组患眼x波与其术后一月获得的最佳中心视力作比较.结果白内障组与对照组比较,x波检出率分别为79.62%和81.63%,统计学分析差异无显著性(P＞0.5),但术前振幅(125.36±38.85μv)明显小于对照组(160.98±23.74μv)(P＜0.01);术前检出x波者其振幅(125.36±38.8μv)及术后视力(0.85±0.22)明显大于检出单峰b波者(73.51±38.78μv,0.28±0.20)(P＜0.01)结论红光ERG能较客观地评价白内障患者术前黄斑部(视锥细胞)功能,x波的测定是预测白内障术后视力恢复的较好方法.     

F-ERG和M-ERG联合检测白内障术前视功能

目的　检测白内障眼术前视网膜功能。方法　对拟行白内障摘出术眼术前分别行暗适应F ERG时域分析法和M ERG频域分析法检查 ,比较白内障合并黄斑部视网膜病变 (黄斑变性、裂孔、出血 ,中心性脉络膜视网膜病变等 )眼、白内障合并周边视网膜病变 (高度近视视网膜格子样变性、通常型视网膜色素变性等 )眼与单纯白内障眼术前F ERG最大混合反应振幅、M ERGflicker 30Hz频谱间的差异。结果　白内障合并黄斑部视网膜病变眼术前F ERG最大混合反应a、b波振幅与单纯白内障组比较差异无显著性(P >0 0 5 ) ,而M ERGflicker 30Hz频谱比较 ,1环的差异有显著性 (P <0 .0 1) ;白内障眼合并周边视网膜病变组术前F ERG最大混合反应a、b波振幅与单纯白内障组比较差异有显著性 (P <0 0 1) ,而M ERGflicker 30Hz频谱比较 ,4～ 5环的差异有显著性 (P <0 0 1)。结论　F ERG时域分析法对白内障合并周边视网膜病变有一定的诊断作用 ,而M ERG频域分析法对白内障合并黄斑部视网膜病变的检测较F ERG敏感 ,F ERG、M ERG联合检测有助于更好地评价白内障眼术前视网膜功能。     

中药复明片对视网膜脱离术后患者视网膜电图的影响

目的:评价益气养阴、活血利水之复明片对视网膜脱离复位术后患者视网膜电图(electroretinogram,ERG)的影响。方法:将386例视网膜脱离复位术的患者,术前常规检查后,通过抽签随机分为复明片治疗组、益脉康片对照组和常规疗法对照组。各组患者均行视网膜脱离复位术,术后常规抗炎、止血治疗,术后1d开始分别服用复明片、益脉康片,常规疗法对照组不另服药。术后随访6wk。记录并对比分析3组患者视力、视网膜电图的变化情况。结果:治疗组视力的有效率为90.0%,与益脉康片对照组(80.6%)及常规疗法对照组(50.4%)比较统计学上有极显著性差异(P<0.01)。复明片组与益脉康组及常规疗法组比较,在治疗后暗适应和明适应ERGa,b波振幅及治疗前后暗适应和明适应a,b波振幅的差值有极显著性意义(P<0.01),治疗后a,b波振幅提高,潜时较短。结论:复明片能改善视网膜复位术后患者的ERG,促进其视功能的恢复。     

白内障手术前视觉电生理测定的意义

目的：探讨白内障手术前视觉电生理检查,评估视功能的价值。方法：回顾性白内障患手术前闪光视网膜电流图(flash electrotinogram,F-ERG)暗适应、闪烁反应,闪光视诱发电位F-VEP及多焦视网膜电图m-ERG (First orderkernel,FOK一阶反应)检查与正常对照组结果分析,及其与术后视力、眼底情况的关系。结果：白内障手术前闪光视网膜电图F-ERG暗适应、闪烁反应检查呈降低型,多焦视网膜电图m-ERG中心反应密度低平,高度近视、眼底病白内障下降更明显,伴有闪光视诱发电位F-VEP异常术后视力差。结论：白内障手术前视觉电生理检查有助于视功能的评估,提高预测术后视力的准确性。     

低温对眼电生理的影响

正常有色兔30只,分为37℃、0℃、-5℃三组,经封闭式玻璃体切除术后,采用三种不同温度灌注1小时。于术前及术后1周、2周、1月分别作各眼明暗适应,不同强度闪光视网膜电图(ERG),所得a、b波振幅数据输入电子计算机进行差异性分析,显示-5℃在术后1周ERG的a波振幅与术前有显著性差异。提示过低温度会损害视网膜功能,在眼低温玻璃体手术中不宜采用。     

复明片对视网膜脱离复位术后视神经功能恢复的疗效

目的：评价中药复明片对视网膜脱离复位术后患者视神经功能恢复的疗效。 方法：采用分组对照研究的方法,将我院2010-01/2013-01收治的视网膜脱离复位术患者60例,根据治疗方法随机分为复明片治疗组（观察组）30例和甲钴胺注射液治疗组（对照组）30例。随访6wk,记录并对比分析两组患者视力、眼压、眼底情况以及视网膜神经纤维层厚度（ RNFLT）。 结果：观察组视力、眼底有效率分别为90%,97%,对照组分别为77%,80%,两组比较差异有显著统计学意义（ P〈0.01）。两组患者在治疗后暗适应和明适应ERG a、b波振幅及治疗前后暗适应和明适应a、b波振幅的差值有显著性意义（P〈0.05）,而眼压无明显统计学差异（P〉0.05）。 结论：复明片能促进视网膜复位术后视网膜下液体的吸收,促进视神经恢复,改善视功能。     

预测白内障患者术后视力的两种方法比较

目的 探讨准确评估晶状体不同混浊程度白内障患者术后视功能的方法。方法 采用视觉电生理和视网膜计两种检查方法,评估152例（152只眼）白内障患者术后的视功能情况,分别将闪光视网膜电图（flash electroretinogram,F-ERG)、闪光视觉诱发电位（flash visual evoked potentials,F-VEP)及潜视力（potential visual acuity,PVA)结果与患眼术后最佳矫正视力(best corrected visual acuity,BCVA)进行相关性分析。结果 对于晶状体不完全混浊者,术前F－ERG b波和F－VEP波振幅的综合值及PVA与术后BCVA呈显著正线性相关性（r=0.528,0．654;P＜0．05）;对于晶状体近完全及完全混浊者,术前F－ERG b波和F－VEP振幅的综合值与术后BCVA呈显著正线性相关性（r＝0．487,P＜0．05）,术前PVA与术后BCVA无显著相关性（r=0．049,P＞0．05）。结论 视觉电生理和视网膜计两种检查方法均可较准确评估晶状体不完全混浊患者术后的视功能,其中视网膜计的检查结果更具预测性;F－ERG和F－VEP检查结果可综合评估晶状体近完全及完全混浊患者术后的视功能,视网膜计检查方法以此类患者术后视力进行评估的准确性欠佳。     

玻璃体切除术前预测术后视力的研究

目的:探讨预测玻璃体视网膜病变患者行玻璃体切除术后视功能的方法。方法:采用术前光定位、辨色力和视觉电生理检查方法,评估24例各种原因所致玻璃体出血或混浊,眼底不能窥入的患者行玻璃体切除术后视功能情况。分别将术前光定位、辨色力和闪烁光VEP,常规闪光ERG结果与患者术后3wk最佳矫正视力进行相关性分析。结果:玻璃体出血或混浊术后视力与术前光定位、辨色力无相关性,与闪烁光VEP的振幅具有显著相关性,r=0.591,P=0.008。与术前明视白光ERG的a,b波振幅具有较显著相关性,r=0.549,0.495,P=0.015,0.031。结论:术前光定位和辨色力不能判定玻璃体切除术后的视功能情况,术前闪烁光VEP和明视白光ERG可以对术后视力进行准确预测。     

Preoperative electroretinogram for predicting postoperative visual function of vitrectomy

Vitrectomy was performed on 17 patients [19 eyes] who had dense vitreal opacity and precluding inspection of the ocular fundus. The preoperative visual acuity was light perception to 0.1, the postoperative visual acuity was 0.03 to 0.9. The preoperative electroretinogram [ERG] was tested on all patients. The correlation of the amplitudes of the ERG b-wave to the postoperative visual acuities were statistically analysed. The results showed that there was positive correlation of the amplitude of the preoperative scotopic bright ERG b-wave to postoperative visual acuity [r = 0.7709, p less than 0.01], and positive correlation of the amplitude of the preoperative photopic ERG b-wave to the visual acuity [r = 0.8086, p less than 0.01]. It suggests that the bigger amplitude of the preoperative ERG b-wave was, the better postoperative visual acuity was improved. Thus, the preoperative ERG could predict the outcome of vitrectomy in various ocular diseases with vitreal opacities and very low visual acuity.     

WHO白内障混浊分级与F—ERG最大反应关系的探讨

目的 观察白内障晶状体混浊对闪光视网膜电流图（F－ERG）最大混合反应（MCR）的影响。方法 对56眼白内障按WHO（1995年）晶状体混浊标准分级;测定其术前和术后3月的MCR;将手术前后F－ERGa,b波振幅差值与晶状体混浊度作对比以评价不同白内障对F－ERG振幅的影响。结果 白内障术后F－ERGa,b波振幅较术前有不同程度增大;核性混浊者手术前后振幅差值较皮质性混浊明显增大（P＜0．01）。结论 混浊晶状体具有光吸收效应并减弱F－ERG反应,核性白内障对MCR振幅的影响较皮质性大,白内障后期可明显影响视功能。     

视觉电生理检查对白内障患者术后视力的评估

目的:评价闪光视觉诱发电位(flash visual evoked potentials,FVEP)和闪光视网膜电图(flash electroretinogram,FERG)或图形视网膜电图(pattern electroretinogram,PERG)对白内障患者术后视力预测的可靠性。方法:对412例白内障患者术前应用GT-2000NV型眼电生理自动测试仪,根据FVEP和FERG(或PERG)结果对白内障术后最佳矫正视力(best-corrected visual acuity,BCVA)进行相关性分析。结果:术前FERGb波和FVEP振幅的综合值与术后BCVA呈显著正线性相关性(r=0.492,0.487;P<0.05)。结论:视觉电生理检查结果可综合评估白内障患者术后的视功能状况。     

Quantitative evaluation of electroretinogram before cataract surgery

The ERGs (electroretinogram) of dense mature cataractous eyes were compared with those of the fellow eyes with good visual acuity in 22 senile patients who showed normal preoperative ERG. The mean amplitudes of the a- and b-waves were slightly reduced in the cataractous eyes as compared to those of the fellow eyes, but the difference was not significant. The light-absorbing effect of the cataract based on the a- and b-wave amplitudes was 0.5 log units. Another group of 13 eyes with senile mature cataract showed abnormal preoperative ERG. Chorioretinal atrophy was the most common cause of the subnormal ERG. Postoperative visual acuity was lower in cataractous eyes with subnormal ERGs than in eyes with normal ERGs. Despite the fact that it does not always reflect the macular function and the visual pathway, the ERG still remains a reliable guide in evaluating the visual prognosis before cataract surgery.     

Preoperative electroretinograms and visual evoked cortical potentials for predicting outcome of vitrectomy in diabetics

In order to find that the outcome of vitrectomy could be predicted in diabetics with very low visual acuity (finger counting at 3 m--approximately 20/400--or less), flash electroretinograms (ERG) and visual evoked cortical potentials (VECP) were simultaneously recorded from about 300 patients within one month before the operation. From this series two groups were formed, based on the outcome of surgery. One group (30 patients) had improved visual acuity, with finger counting at 0.1 to 1.0 m (20/200-20/20). The other group (29 patients) was unimproved by surgery. The groups were matched with regard to age, duration of diabetes, preoperative visual acuity and occurrence of cataract and previous panretinal photocoagulation. All patients had dense vitreal opacities, precluding inspection of the ocular fundus. Only patients without surgical and postoperative complications were included. There was a statistically significant (P less than 0.05) difference between the groups in ERG amplitude, but not in VECP latency or amplitude. Based on ERG amplitude, the outcome of vitrectomy could be predicted correctly in 36 of 59 patients (61%) and in 35 of 56 patients (63%) based on VECP latency. The VECP amplitude or the combination of ERG and VECP parameters did not improve the prediction rate. Thus, preoperative flash ERG and VECP can not safely predict the outcome of vitrectomy in diabetics with very low visual acuity.     

Electrophysiological findings in two young patients with Bothnia dystrophy and a mutation in the RLBP1 gene

Purpose: To characterize the clinical phenotype, with emphasis on electrophysiology, of two children with suspected Bothnia dystrophy. Methods: Two unrelated affected patients, 10 and 11 years old, were studied. Ophthalmological examination included testing of visual acuity, fundus inspection and fundus photography, kinetic perimetry, full-field electroretinogram (ERG), and multifocal ERG. The presence of a mutation in exon 7 of the RLBP1 gene was investigated by DNA sequencing. Results: Both patients were homozygous for the Arg234Trp-causing mutation in the RLBP1 gene, but the resulting disease phenotype appeared to vary somewhat between them. Visual acuity was moderately reduced in one patient and normal in the other. Fundus inspection at this age revealed no pathology in either patient and there were no signs of retinitis punctata albescens, which has been described previously as a frequent clinical feature of Bothnia dystrophy. The result of kinetic perimetry was normal. The final rod threshold was moderately elevated. Full-field ERG demonstrated the uncommon combination of absent rod response and normal cone response after 40 minutes of dark adaptation. However, after prolonged dark adaptation (20–24 h), both the rod response and the dark adaptation threshold became normal. Multifocal ERG was performed in one of the patients (the one with normal visual acuity and normal fundus appearance) and showed a reduced cone response in the central region of the tested area. There was no improvement of the multifocal ERG result after 20–24 h of dark adaptation. Conclusion: Patients with mutations in the RLBP1 gene (Arg234Trp) may have a normal fundus appearance early in the disease course. Multifocal ERG can be used for the objective documentation of the disturbed macular function, especially when the patient's visual acuity and fundus appearance are normal. The rod response is absent in the electroretinogram; however, after prolonged dark adaptation (20–24 hours), the rods recover completely. The central cones do not seem to recover.     

Electroretinogram b/a wave ratio improvement in central retinal vein obstruction.

The electroretinogram (ERG), especially the b/a wave ratio, is considered a good indicator of retinal ischaemia in central retinal vein obstruction (CRVO). Seven CRVO patients who showed b/a wave ratio improvement from < 1.0 [negative type (-) ERG] to > or = 1.0 and one from 1.07 to 1.53 were studied. Three mechanisms of change were observed: firstly, the b-wave amplitude increased without an a-wave amplitude decrease (group A, n = 2); secondly, the b-wave amplitude increased with an a-wave amplitude decrease (group B, n = 4); and, thirdly, both decreased, but the a-wave amplitude decreased more markedly (group C, n = 2). In group A, the visual acuities improved markedly. In group B, the visual acuities improved in two cases in which the b-wave amplitude reached the normal range; the visual acuities did not improve in two cases in which the b-wave amplitude did not reach the normal range. In group C, the visual acuities remained poor. The negative (-) ERG or significantly reduced b/a wave ratio is associated with ischaemic CRVO and did not occur because of the filtering effect of the haemorrhage, which may reduce the stimulus light for the ERG. Improvement of the reduced b/a wave ratio with an increased b-wave amplitude was accompanied by improvements in fundus appearance and visual acuity in CRVO. The results suggest that the retinal ischaemia in CRVO, as revealed by the ERG and fluorescein angiogram, may be reversible in some cases.