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。     

散发型视网膜色素变性患者的多焦视网膜电图检查

视网膜色素变性 (retinitis pigm entosa,RP)是一种严重的致盲性眼病 ,其临床特征是早期出现夜盲及视野缩窄 ,晚期出现视力下降甚至丧失 ,视网膜周边部色素沉积 ,全视野视网膜电流图 (electroretinography,ERG)检查波幅低平甚至消失[1 ] 。因此 ,视力、视野和全视野 ERG检查结果是该病的主要诊断依据。但是 ,全视野 ERG是对整个视网膜功能的反应 ,无法对视网膜局部功能的改变做出准确反应。而多焦视网膜电图 (multi-focal electroretinography,m ERG)是一种近年来出现的能同时记录许多局部 ERG的视觉电生理技术 ,可以同时分别刺激视…     

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。     

黄斑囊样水肿的多焦视网膜电图

目的:评价黄斑囊样水肿患者于视网膜后极部不同部位的视功能。 方法:应用VERIS 4.0视诱发反应仪检测了黄斑囊样水肿24例27只眼(包括中央静脉阻塞,糖尿病性视网膜病变,葡萄膜炎)的多焦视网膜电图(multifocal electroretinogram,mfERG),年龄30～75岁,平均(55.58±13.31)岁,病程均在1年以上;正常对照组为25例29只眼,年龄34～71岁,平均(51.08±9.27)岁。记录后极部26.6°X22.1°视野内103个视网膜区域的一阶反应曲线和三维功能图。 结果:黄斑囊样水肿患者的mfERG的N1波和P1波的潜伏期于全区和6个环区域均较正常对照组明显延迟(P<0.01)。于1、2、3环N1波的平均反应密度降低,与对照组比较均有非常显著性差异(P<0.01),而于4、5、6环区平均反应密度无显著性改变(P>0.05),P1波的平均反应密度于全区和6个环区域与对照组比较均有显著性差异(P<0.05)。 结论:mfERG是评价黄斑囊样水肿于视网膜后极部不同部位视功能的有效工具。N1波的反应密度是分析黄斑水肿较好的指标。眼科学报 2003;19:253-256。     

多焦视网膜电图技术及临床应用

多焦视网膜电图是视觉电生理学的一项重要新进展,它应用先进的数字信号处理和电子计算机技术,可在较短时间内同时测量几十度视野范围内几十到几百个区域的局部视网膜电图,并计算各局部反应的一阶反应和二阶反应,根据各反应的参数分 别了解视网膜内外层对应于视野各部位的功能,目前该技术已在临床上得到应用。（中华眼底病杂志,2000,16：1-70）     

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)     

正常儿童多焦视网膜电图的特征

目的研究正常儿童多焦视网膜电图的波形特征,为相关临床及科研工作提供依据。方法采用VERISScienceTM4.2多焦电生理系统对30例正常儿童双眼分别进行mfERG的一阶反应检查,对不同离心度及不同视网膜区域的波形特征进行分析。结果mfERG反应振幅密度随离心度增加而减小,上下半侧视网膜反应无明显差异,与颞侧视网膜相比,鼻侧视网膜反应振幅密度降低,潜伏期延长。结论mfERG可用于研究不同离心度和不同视网膜区域的反应,为临床应用提供依据。     

Stargardt病的多焦视网膜电图

目的观察Stargardt病多焦视网膜电图(multi-focal electrore tinogram, mERG)变化特点。方法用VERIS 4.0视觉诱发反应成像系统 ,对7例Stargardt病患者的14只患眼进行mERG测定,并与正常对照者的mERG检查结果进行比较。结果接受检查的所有Stargardt病患眼的mERG均有显著异常,各部位mERG N₁、P₁波振幅明显降低 ,潜伏期明显延长(P<0.01);不同部位N₁、P₁振幅降低程度不一致,以中心凹振幅降低最为显著,平均振幅分别只相当于正常人的19%和10%,随着离心度的增大,振幅差异逐渐减小;患者mERG地形图可分为中心降低型和弥漫降低型2种形式。结论Stargardt病的mERG有明显异常改变,表现为黄斑中心凹功能损害最严重。(中华眼底病杂志,2001,17:271-273)     

380例高度近视眼多焦视网膜电图特点

目的分析高度近视眼患者的多焦视网膜电图分布特征,探讨高度近视眼患者早期视网膜功能改变。方法连续收集高度近视眼患者380例（720眼）和正常对照者280例（560眼）,采用德国Roland公司生产的RETIscan多焦视觉电生理检查系统,记录一阶反应的P1波波形与数值,分析比较其5个环形视网膜区域的变化情况。结果 380例高度近视组5个环形视网膜区域的P1波平均反应密度值、振幅总和值均低于正常对照组,潜伏期值比对照组明显延长,其中以1环和2环改变最为明显,P〈0.05。结论高度近视眼患者多焦视网膜电图的反应密度、振幅均降低,潜伏期延长,以黄斑中心凹区域改变最为明显,说明高度近视眼患者的早期视网膜损害主要发生于黄斑中心凹区域。     

视网膜色素变性黄斑区视网膜FD-OCT及mfERG观察

目的　利用频域光学相干断层扫描（ｆｒｅｑｕｅｎｃｙｄｏｍａｉｎｏｐｔｉｃａｌｃｏｈｅｒｅｎｃｅｔｏｍｏｇｒａｐｈｙ,ＦＤ-ＯＣＴ）及多焦视网膜电图（ｍｕｌｔｉ-ｆｏｃａｌｅｌｅｃｔｒｏｒｅｔｉｎｏｒｇｒａｍ,ｍｆＥＲＧ）观察视网膜色素变性（ｒｅｔｉｎｉｔｉｓｐｉｇｍｅｎｔｏｓａ,ＲＰ）患者黄斑区视网膜图像特征。方法　选取临床确诊的ＲＰ患者３０例（３０眼）作为ＲＰ组,年龄相匹配的健康人３０人（３０眼）作为对照组。采用ＦＤ-ＯＣＴＲＴＶｕｅ的Ｅ-ＭＭ５扫描模式对５ｍｍ×５ｍｍ范围的黄斑中心视网膜进行检测,获取视网膜厚度及内、外层视网膜容积,同时采用ＲＥＴＩｐｏｒｔ视觉电生理系统测量ｍｆＥＲＧ,对两组测量结果进行比较分析。结果　ＲＰ组视网膜黄斑中心凹厚度为（１４０．８０±１９．２５）μｍ,对照组为（１６５．９１±１４．３９）μｍ,差异无统计学意义（Ｐ＞０．０５）。ＲＰ组黄斑区外层视网膜体积为（３．６１±０．１８）ｍｍ３,低于对照组（４．５９±０．１１）ｍｍ３,差异有显著统计学意义（Ｐ＜０．００１）。ＲＰ组黄斑区内层视网膜体积为（２．２８±０．１０）ｍｍ３,对照组为（２．３０±０．１０）ｍｍ３,两组比较差异无统计学意义（Ｐ＞０．０５）。ＲＰ组ｍｆＥＲＧ各环Ｎ１、Ｐ１波反应密度值均低于对照组,且差异均有统计学意义（均为Ｐ＜０．０５）。ＲＰ组Ｎ１、Ｐ１波３～５环的潜伏期较对照组显著延长,差异均有统计学意义（均为Ｐ＜０．０５）。结论　ＦＤ-ＯＣＴ和ｍｆＥＲＧ相结合可有效评价ＲＰ患者视网膜功能及形态特点。     

Principal components' analysis of multifocal electroretinogram in retinitis pigmentosa

Aims:

To determine waveforms of multifocal electroretinogram (mfERG) in patients with retinitis pigmentosa (RP) contributing significantly to the overall retinal response by using principal components’ analysis.

Settings and Design:

Prospective, non-randomized, single-visit, observational, case-control study from a single tertiary ophthalmic center.

Materials and Methods:

Patients with various forms of RP underwent mfERG testing for a period of one year. The first-order kernel responses of RP cases were compared with concurrently recruited healthy controls.

Statistical Analysis Used:

Parametric data was analyzed using the unpaired t test for differences between the implicit time and amplitudes of cases and controls. Principal components’ analysis was done for each implicit time and amplitude in cases with RP using the Varimax rotation method.

Results:

From March 2006 to March 2007, 24 cases with typical RP (56%, 47 eyes) were included in the final analysis. Their mean age was 33.7 years (19-69 ± 15.5 years). Comparison of latencies and amplitudes among RP cases with log MAR acuity ≤ 0.18 and those > 0.18, revealed significant difference in the implicit time (P1) in Ring 2 only (P=0.028). Two components (predominently from Ring 1 and 2) each contributing 66.8% and 88.8% of the total variance in the data for latencies and amplitudes respectively, were seen.

Conclusions:

The first two rings of the mfERG contributed to the variance of waveforms in RP, irrespective of the visual acuity and poor visual field results.     

Flicker electroretinogram in retinitis pigmentosa

Electroretinograms (ERGs) were recorded as a function of flicker frequency from 5 to 50Hz for 14 retinitis pigmentosa (RP) patients, 12 normal subjects and 1 rod monochromat. Data were analyzed by measuring the angular position of the response maximum, i.e. the phase, as a function of pulse-train frequency. Flicker ERGs obtained from the RP patients showed non-linear, frequency-dependent phase shifts when compared to the normal data. These phase shifts were simulated in a normal observer by attenuating the stimulus luminance by 1 log unit. However, the shape of the waveforms recorded from the normal differed markedly from those recorded from the RP patients. The differences, but not the ratios of the times-to-peak of the positive and negative ERG wavelets were longer in the RP patients than in the normal. These data suggest that the temporal anomalies in the RP flicker ERG are most likely due to changes in the amplitudes and time constants of the ERG components, and not simply to a reduced quantum catch or photoreceptor loss.Supported by research and core facility grants from the National Institutes of Health (EY-01791 and EY-01765)     

L- and M-cone driven large-field and multifocal electroretinograms in sector retinitis pigmentosa

The purpose was to study long- (L-) and middle-wavelength-sensitive (M-) cone-driven ERGs and multifocal ERGs (mfERGs) in sector retinitis pigmentosa (sector RP). Two eyes of two patients with sector RP were measured. ERG responses were measured to stimuli which modulated exclusively the L- or the M-cones or the two simultaneously (both in-phase and in counter-phase) with predefined cone contrast leaving the S-cones unmodulated. For comparison, mfERGs were recorded with the visual evoked response imaging system, using a resolution of 61 hexagonal elements within a 30-degree visual field. The two sector RP patients exhibited a general reduction of the L-/M-cone driven ERG sensitivity. Patient 1 exhibited a slight delay of the M-cone driven ERG. In patient 2, L-cone driven ERG was moderately delayed. In both patients, the phases of the L- and the M-cone driven ERGs were positively correlated with cone contrast. The data of the L/M-cone driven ERGs, the mfERGs and the standard photopic ERGs matched each other qualitatively. We conclude that the sector RP patients were clearly different from normal for both the L- and M-cone driven large-field and the multifocal ERGs. Previously, we investigated L- and M-cone driven ERGs in patients with generalized RP and found several features that differ from the sector RP patients. Our data are in agreement with our previous proposition that amplitudes and phases of the L- and M-cone driven ERGs can be differently affected by retinal disorders.     

Light rise of the human electroretinogram is normal in retinitis pigmentosa

Aim: To determine if the electroretinogram (ERG) light rise is reduced below normal in patients with retinitis pigmentosa (RP) and whether it is greater in patients with smaller ERG. Methods: Both eyes of 31 normal subjects and 59 subjects with RP had photopic ERGs on ISCEV standard and brighter backgrounds, before and after dark adaptation. Recordings <2.5 µV were excluded. Results: Ratios of amplitudes before and after dark adaptation varied little. The b‐wave averaged 1.88 (SD 0.41) in normal subjects and 1.66 (SD 0.62) in RP subjects, and a‐waves averaged 1.44 (SD 0.42) and 1.31 (SD 0.73), respectively. None of eight t?tests were significant (<2.4). There was a positive (not negative) correlation between RP subjects’ initial b‐wave amplitude and light rise but not for a‐waves. A‐wave light rises were smaller. Conclusion: Retinitis pigmentosa does not reduce the light rise of recordable ERG. The light rise of the ERG is larger in those RP subjects with larger initial b‐waves. This confirms previous findings. The difference between a‐ and b‐waves in RP suggests post‐receptoral processes are involved.     

The multifocal electroretinogram in retinal detachment

We evaluated the retinal electrophysiologic function in both the detached and attached areas of eyes with retinal detachment, and assessed the functional recovery of these areas after surgery by quantifying the results, obtained from multifocal electroretinograms. Multifocal electroretinographic recordings and central 0°, to 30°, visual field tests were performed preoperatively and 2 weeks 1, 3 and 6 months postoperatively in 12 patients with unilateral retinal detachment. Each patient's response to the multifocal electroretinogram and the visual field test was classified into two groups: group A, the response from the attached area; and group B, that from the detached retinal area. Individual mean deviation and percentage mean deviation were calculated for each group. All retinal detachments were successfully reattached by the conventional scleral buckling method. The retinal sensitivity in the visual field test of all the patients in group B greatly improved. However, the percentage mean deviation in the response density of the multifocal electroretinogram in group B was −81% preoperatively and −63% at 6 months postoperatively. Thus, the improvement was confined within narrow limits. The response density of the multifocal electroretinogram in group A was very low, and never improved beyond −50% of percentage mean deviation. In the eyes with retinal detachment, electroretinogram response in both the attached and detached areas was more disturbed, than predicted by means of the visual field test during the course of this study.     

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。     

多焦视网膜电图检测糖尿病早期视功能的变化

目的：了解多焦视网膜电图（mfERG）在糖尿病患早期视功能的变化规律。方法：将所有被检分为正常对照组（33例）、糖尿病无视网膜病变组（63例）以及单纯期糖尿病视网膜病变组（43例）。采用mfERG对上述3组进行检测,比较3组mfERG一阶反应N1波与P1波的潜伏期与反应密度。结果：在糖尿病无视网膜病变组中,N1波与P1波反应密度低于正常对照组,异常范围位于环1一环3。其中P。波反应密度在单纯期糖尿病视网膜病变组中进一步降低。N1波与P1波的潜伏期在糖尿病无视网膜病变组中的变化无统计学意义,在糖尿病视网膜病变组中延长,异常范围扩大到环4与环5。结论：mfERG在糖尿病视网膜病变出现之前已发生异常变化,且能够定量地反映随着病情的进展,视功能的损害程度及范围。     

Early changes of retinal function in diabetic patients detected by multifocal electroretinogram

To investigate the early changes of retinal function in diabetic patients detected by multifocal electroretinogram (mfERG). ·METHODS: The first-order kernel responses of mfERG were recorded fromeyes of 33 normal control subjects, 63 diabetic patients without retinopathy and 43 diabetic patients with background retinopathy. The response densities and implicit times of N₁ and P₁ were compared among the control, diabetic patients without retinopathy and diabetic patients with retinopathy. ·RESULTS: The response densities of N1 and P1 in central 3 rings were reduced significantly in diabetic eyes with and without retinopathy. And the implicit times of N₁ and P₁ were delayed significantly only in diabetic eyes with retinopathy. ·CONCLUSION: mfERG can detect the early changes of retinal function quantitatively in diabetic patients. Analysis of response densities and implicit times of N₁ and P₁ can reflect the progress of local retinal dysfunction in diabetes