黄斑病变的局部视网膜电图检测

目的记录几种黄斑病变的局部视网膜电图（ｌｏｃａｌｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ,ＬＥＲＧ）,确定其在黄斑病变诊断中的应用价值。方法采用局部光刺激器,对五种类型黄斑病变患者进行黄斑区２．５°、５．０°、７．５°三个范围的ＬＥＲＧ测定。结果（１）在所观察的黄斑病变中,Ｓｔａｒｇａｒｄｔ病、湿性老年黄斑变性、黄斑裂孔及中心性浆液性脉络膜视网膜病变的ＬＥＲＧ振幅较正常对照组降低,差异有显著性（Ｐ＜０．０１）,且异常率较高;干性老年黄斑变性及黄斑部视网膜前膜的ＬＥＲＧ振幅则无显著改变。（２）ＬＥＲＧ异常率也与刺激范围有关。在所观察记录的三个范围中,以２．５°的ＬＥＲＧ异常率最高。结论不同类型黄斑病变对黄斑区视网膜电活动的影响程度存在总体差异。ＬＥＲＧ是测量黄斑功能的一种有效的电生理方法。     

黄斑部病变的局部视觉电生理测定

本文对５种类型黄斑病变同时进行了黄斑局部视网膜电图（ＬＥＲＧ）及局部视觉诱发电位（ＬＶＥＰ）测定。结果显示：湿性型老年黄斑变性、Ｓｔａｒｇａｒｄｔ＇ｓ病、中心性浆液性视网膜脉络膜病变及特发性黄斑洞等２．５°及５°范围ＬＥＲＧ振幅显著降低并且异常率较高，而干性ＡＭＤ及视网膜前膜ＬＥＲＧ改变不明显。所有黄斑病变ＬＥＲＧ的异常率要高于ＬＶＥＰ。结果表明：ＬＥＲＧ能客观地测量黄斑病变的黄斑功能变化，其检测敏感性要高于ＬＶＥＰ。     

图形视觉诱发电位鉴别伪盲的临床应用研究

目的　用图形视觉诱发电位（ｐａｔｔｅｒｎｖｉｓｕａｌｅｖｏｋｅｄｐｏｔｅｎｔｉａｌ,Ｐ-ＶＥＰ）来评价客观视力以及用来鉴别伪盲的临床应用价值。方法　取志愿受检者１５８例（１５８眼）患黄斑病变或视神经病变眼,其中６５眼为黄斑病变组（Ａ组）,９３眼为视神经病变组（Ｂ组）,通过多元回归分析Ｐ-ＶＥＰ波幅和潜伏期与最佳矫正视力的关系。由此得出最佳关系方程,进而得出１５８眼Ｐ-ＶＥＰ推算视力（ＰＶＥＰ-ＶＡ）,以及５３只伪盲眼（包括２１眼黄斑病变及３２眼视神经病变）的ＰＶＥＰ-ＶＡ,最后用受试者工作特征曲线（ＲＯＣ曲线）得出可接受ＰＶＥＰ-ＶＡ及主观视力差值范围,从而鉴别伪盲。结果　在１５′视角黑白棋盘格刺激下引出的Ｐ-ＶＥＰ波形,该波形的Ｐ１００波幅（记录为Ａｍｐ１５′）与主观视力的相关性最好,Ａｍｐ１５′与主观视力显著相关（Ａ组:Ｐ＝０．０１６;Ｂ组:Ｐ＜０．０００１）。Ａｍｐ１５′的对数［ｌｏｇ（Ａｍｐ１５′）］与主观视力（ｌｏｇＭＡＲ）的回归方程为:Ａ组:ｙ＝１．８６７－１．１００ｘ,Ｐ＜０．０００１,Ｂ组:ｙ＝１．５０２－０．７９９ｘ,Ｐ＜０．０００１［ｘ为ｌｏｇ（Ａｍｐ１５′）,ｙ为ｌｏｇＭＡＲ］。利用回归曲线和ＲＯＣ曲线可以得到Ａ组辨别伪盲的截断值为０．３９７２时,其诊断敏感性为７３．３％,特异性为６８．０％;Ｂ组辨别伪盲的截断值为０．４１５０,其诊断敏感性为９０．５％,特异性为６７．５％。结论　Ｐ-ＶＥＰ的Ａｍｐ１５′用来判断客观视力最有效,对于鉴别伪盲也很有意义。     

特发性老年性黄斑裂孔的图形视诱发电位和视网膜电图

对１２例（１５只眼）特发性老年性全层黄斑裂孔病人行图形ＶＥＰ和闪光ＥＲＧ测定。１５＇棋盘方格刺激图形ＶＥＰ的异常率为９３．３％，其改变为Ｐ１００的潜伏期延迟，振幅降低或畸形波。闪光ＥＲＧ的异常率为５３．３％，主要呈视锥细胞的ｂ波降低。两者异常率的差异有显著性（Ｐ〈０．０５）。黄斑裂孔晕轮直径与Ｐ１００潜伏期呈线性正相关（ｒ＝０．８２，Ｐ〈０．０１），但裂孔直径与Ｐ１００潜伏期无相关（Ｐ〉０．０５…     

定量测量视网膜神经纤维层厚度联合视觉电生理检查开角型青光眼

目的 比较光学相干断层成像术（ＯＣＴ）测量视网膜神经纤维层（ＲＮＦＬ）厚度与视觉电生理检查在原发性开角型青光眼（ＰＯＡＧ）早期损害中的敏感性并分析其间相互关系。方法 对早期、进展期或晚期ＰＯＡＧ患者２６例（５０眼）联合进行ＯＣＴ及ＰＥＲＧ、ＰＶＥＰ和ＯＰｓ的检查。结果 ＯＣＴ测量ＲＮＦＬ厚度在ＰＯＡＧ早期中的异常率为４０．９１％,低于ＰＥＲＧ（７８．９５％）和ＰＶＥＰ的异常率（６４．６４％）,高于ＯＰｓ（２８．５７％）。ＲＮＦＬ百度与ＰＶＥＰ和ＰＥＲＧ振幅显著正相关,与ＰＶＥＰ潜伏期负相关,与ＯＰｓ总值不相关。结论 联合ＯＣＴ测量ＲＮＦＬ厚度与视觉电生理检查更有利于青光眼的早期诊断。     

正常眼和老年黄斑变性眼的局部视网膜电图

以全视野亮背景及４５′视角的红色闪光作刺激，采用带中孔的角膜接触镜电极，记录了局部视网膜电图。测得２２只正常眼的黄斑中心对盲点区的局部ＥＲＧ振幅之比值为３．５４±１．３５，而３１只老年黄斑变性眼的比值是１．３９±０．５４，两者差异显著（Ｐ＜０．０１），两组全视野明适应ＥＲＧ间无意义，表明此法建立的局部ＥＲＧ记录技术对早期老年黄斑变性病人具有一定诊断价值。     

增殖性糖尿病视网膜病变患者玻璃体中血管内皮细胞生长因子含量的检测

目的检测增殖性糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）患者玻璃体中血管内皮细胞生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ，ＶＥＧＦ）的含量并与正常人进行对比研究，探讨ＶＥＧＦ在ＰＤＲ病理过程中的作用。方法应用酶联免疫吸附测定法（ｅｎｚｙｍｅｌｉｎｋｅｄｉｍｍｕｎｏｓｏｒｂｅｎｔａｓｓａｙ，ＥＬＩＳＡ）对７例正常人及１９例ＰＤＲ患者玻璃体中的ＶＥＧＦ进行定量分析研究。结果７例正常人玻璃体中，ＶＥＧＦ的含量为０．１８～０．６０ｎｇ／ｍｌ，平均值为０．３５ｎｇ／ｍｌ。１９例ＰＤＲ患者玻璃体中ＶＥＧＦ的含量升高，范围为０．８４～１５．６４ｎｇ／ｍｌ，平均值为５．６６ｎｇ／ｍｌ。两组比较，差异有显著性（Ｐ＜０．０５），其中男性组玻璃体中ＶＥＧＦ的含量为０．８４～１５．６４ｎｇ／ｍｌ，平均值为４．８３ｎｇ／ｍｌ；女性组为１．３４～１２．３４ｎｇ／ｍｌ，平均值为７．０８ｎｇ／ｍｌ，两组比较，差异无显著性（Ｐ＞０．０５）。结论ＰＤＲ患者玻璃体中ＶＥＧＦ的含量升高，在ＰＤＲ的病理过程中起一定作用     

早期糖尿病视网膜病变患者颜色视觉运动觉特性

目的研究早期糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）患者的颜色视觉运动觉的改变，探讨ＤＲ早期诊断方法。方法在ＰＣ兼容机上，应用运动觉测试软件，由微机控制，于ＶＧＡ显示器产生等亮度的颜色光栅条纹和黑白光栅条纹运动，测试早期ＤＲ患者及正常对照者颜色视觉运动觉，并与色觉、视网膜电图（ＥＲＧ）振荡电位（ＯＰｓ）检查结果作比较。结果在时间和空间频率一致时，正常人可观察到等亮度的颜色光栅比黑白光栅运动慢。在黑白光栅亮度对比度为８０％，速度为２０．２ｍｍ／ｓ及１４．３ｍｍ／ｓ时，ＤＲ患者的蓝／黄运动觉和正常人比较，差异有非常显著性（Ｐ＜０．００１）。在黑白光栅亮度对比度为８０％，速度为２０．２ｍｍ／ｓ时，颜色视觉运动觉的异常率（６９．２％）比色觉异常率（４３．６％）及ＥＲＧＯＰｓ异常率（４８．９％）要高。结论颜色视觉运动觉检查提供了一种新的ＤＲ早期诊断方法     

低体重儿P—VEP改变及影响因素的研究

为研究低体重儿（ＬＢＷＩ）视功能发育状态及影响因素，用日本ＮｅｕｒｏｐａｃｋⅡ电生理仪，对３～１０岁１３８例ＬＢＷＩ进行图形视诱发电位（Ｐ－ＶＥＰ）检查，３１例３～１０岁足月正常体重儿作对照组，记录１４６’、７３’、３６．５’三种空间频率的Ｐ１００潜伏期和Ｎ１－Ｐ１振幅。结果：ＬＢＷＩ三种空间频率潜伏期均较对照组延长，其中中、高空间频率组与对照组比较差异有显著性（Ｐ＜０．０５）；三种空间频率的振幅值明显低于对照组，差异有非常显著性（Ｐ＜０．００１）；潜伏期延长和振幅降低主要集中在胎龄＜３２周、体重＜２．０ｋｇ组。多元回归分析示ＬＢＷＩＰ－ＶＥＰ改变与出生体重、胎龄及围产期窒息、脑损害和眼部病变等因素有关。无眼、脑合并症的早产ＬＢＷＩ组的Ｎ１－Ｐ１振幅与对照组比较仍存在统计学差异。结论：ＬＢＷＩ具有视觉发育障碍的高风险，应给予视功能发育的早期监测及随访。     

组织激肽释放酶在糖尿病视网膜病变患者血清中的变化及其调节血管新生机制

目的　检测组织激肽释放酶（ｔｉｓｓｕｅｋａｌｌｉｋｒｅｉｎ,ＴＫＬＫ）、血管内皮细胞生长因子（ｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｇｒｏｗｔｈｆａｃｔｏｒ,ＶＥＧＦ）和可溶性细胞间黏附分子-１（ｓｏｌｕｂｌｅｉｎｔｒａｃｅｌｌｕｌａｒａｄｈｅｎｓｉｏｎｍｏｌｅｃｕｌ-１,ｓＩＣＡＭ-１）在糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＤＲ）患者血清中的变化,观察ＴＫＬＫ在低氧条件下对人视网膜微血管内皮细胞（ｈｕｍａｎｒｅｔｉｎａｌｍｉｃｒｏｖａｓｃｕｌａｒｅｎｄｏｔｈｅｌｉａｌｃｅｌｌｓ,ＨＲＭＥＣｓ）中ＶＥＧＦ和ＩＣＡＭ-１表达的影响。方法　收集２型糖尿病患者６０例,按照ＤＲ分期标准将患者分为糖尿病无ＤＲ组（ＤＭ组）、非增生性ＤＲ组（ＮＰＤＲ组）和增生性ＤＲ组（ＰＤＲ组）,收集同期在本院体检的志愿者作为对照组,每组２０例。ＥＬＩＳＡ法检测血清中ＴＫＬＫ、ＶＥＧＦ和ｓＩＣＡＭ-１的水平。体外ＨＲＭＥＣｓ分别进行常氧和低氧培养,不同浓度重组ＴＫＬＫ处理后,检测细胞增殖、凋亡以及ＶＥＧＦ和ＩＣＡＭ-１的表达。结果　ＤＭ、ＮＰＤＲ和ＰＤＲ组患者血清中ＴＫＬＫ、ＶＥＧＦ和ｓＩＣＡＭ-１水平明显高于对照组,４组总体差异有统计学意义（Ｆ＝２８．８０５,Ｐ＝０．００２;Ｆ＝３２．０４１,Ｐ＝０．００２;Ｆ＝２６．１６９,Ｐ＝０．００１）;ＰＤＲ患者血清中ＴＫＬＫ、ＶＥＧＦ和ｓＩＣＡＭ-１水平显著高于ＤＭ和ＮＰＤＲ组（均为Ｐ＜０．００１）。ＴＫＬＫ与ＶＥＧＦ（ｒ＝０．６２３,Ｐ＜０．０１）和ｓＩＣＡＭ-１水平（ｒ＝０．５９８,Ｐ＜０．０１）均呈正相关。１０μｇ?ｍＬ－１ｒｈＴＫＬＫ可显著抑制低氧诱导的ＨＲＭＥＣｓ增殖以及ＶＥＧＦ和ＩＣＡＭ-１的表达,并可促进细胞凋亡（Ｐ＜０．０５）。结论　ＴＫＬＫ通过与ＶＥＧＦ和ＩＣＡＭ-１相互作用而影响ＤＲ的进展。     

The Study of Local Electrophysiology in Macular Diseases

Purposes: To observe the features and clinical utility values of local electroretinogram (LERG) and local visual evoked potentials(LVEP) in macular diseases. Methods : The spot stimuli were obtained by changing the shutters with different sizes of hole at the posterior of Ganzfeld ball. The recording electrode for LERG was made with the filament of platinum as blepharophthalmostat like. The LERG and LVEP were simultaneously recorded in macular diseases.Results: The exudative AMD, Stargardt's disease, central serous chorioretinopathy and idio-pathic macular hole had seriously decreased amplitudes of LERG and higher abnormal rates, comparing with atrophic AMD and idiopathic preretinal membranes in the region of 2.5° and 5° at macula. The abnormal rates in these diseases were higher for LERG than for LVEP. Conclusion: The LERG can objectively measure the variation of macular function in macu-lopathies. The sensitivities of LVEP are lower than those of LERG for macular diseases. Eye Science 1998; 14; 30 -     

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。     

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。     

图形视诱发电位在弱视诊断及治疗中的应用

研究图形视诱发电位（Ｐａｔｔｅｒｎ Ｖｉｓｕａｌ－Ｅｖｏｋｅｄ Ｐｏｔｅｎｔｉａｌ，ＰＶＥＰ）在弱视诊断和治疗中的应用价值，探讨弱视发病的机制。检测对象分为弱视组（１０８只眼）、正常对照组（１８０只眼）和美多巴治疗组（２６只眼）。以日本光电公司产ＭＥＢ－５１００型诱发反应记录仪进行检测，视觉刺激采用黑白翻转方格，视角为３０’，６０’和９０’，叠加１２８次。弱视组Ｐ１波潜伏时延长，振幅降低。３０’视     

老年黄斑变性的局部视网膜电图研究

目的:观察老年黄斑变性(AMD)对视网膜黄斑部电活动影响特征,并对局部视网膜电图(LERG)的敏感性作出评价。方法:对80例AMD患者99只眼进行了黄斑区三个范围局部视网膜电图(LERG)测定,并与患者的视力及相应检测范围病损面积进行了对比研究。结果:黄斑区2.5°、5°、7.5°范围内,干性AMD组LERG平均振幅降低,但与正常对照组间无显著性差异(P>0.05),湿性AMD组LERG平均振幅显著降低(P<0.01)。湿性AMD LERG b波振幅与病人视力呈正相关性,与相应范围病灶面积呈负相关。干性AMD玻璃膜疣数量对LERG尚无影响。结论:不同类型AMD对于黄斑功能损害程度不同,湿性型损害大于干性型;中心凹功能损害大于旁中心凹。LERG在AMD的黄斑功能测定方面是较敏感的电生理方法。眼科学报 1996;12:93—97。     

Assessment of visual function before and after macular surgery by pattern visual evoked cortical potentials

PURPOSE: To investigate pre- and postoperative visual function in patients with macular hole and those with epiretinal macular membrane (ERM) by means of visual evoked cortical potential (VECP). MATERIAL AND METHODS: VECP was recorded from 15 eyes with macular hole and 9 eyes with ERM prior to and 3 months after surgical treatment. Check sizes of 30' for transient stimulation, and 7.5', 15', 30', 60' and 120' for steady-state stimulation were applied. RESULTS: In transient VECPs, the P 100 component was prolonged and attenuated in both diseases before surgery, and it remained unchanged after surgery. In the eyes with macular hole, the amplitudes of steady-state VECPs showed significant reduction in 15' and 30' check sizes before surgery, and recovered only in 15' check size after surgery. The preoperative spatial frequency curve of ERM was lowered in the whole frequency range measured. CONCLUSIONS: VECP reflected the area of macular hole and ERM. VECP changes after surgery were considered to depend on the degree of surgical invasion.     

Visual Functions and TraceElement Metabolism in Tobacco-toxic Optic Neuropathy

Visual functions and nutrition metabolic characteristics werestudied in 8 subjects(16 eyes)with tobacco-toxic optic neuropathy(TTON).Their visual functions tested by psychophysical and electrophysiologicmethods showed that:1.central vision diminished in 16 eyes,2.dyschromatopsias were found in 14 tested eyes,3.bilateral symmetricalcentral or cecocentral scotomas were the visual field characteristics in allcases,4.PVEP were severe abnormal in 3 spatial frequencies in all cases and56.3% of 15‘ checkboard ...     

Pattern visual evoked potentials visual acuity--the evaluation of visual acuity of less than 0.1

PURPOSE: We previously developed a new method for estimating objective visual acuity by means of pattern visual evoked potentials (PVEP). In this study, this method was applied to the evaluation of visual acuity of 0.05 and 0.01. METHODS: Ten subjects with visual acuity of 0.05 and ten normal subjects with visual acuity of 0.01 were examined. The visual acuity of the subjects was decreased step by step by means of plus spherical lenses of increasing power. In the PVEP study, the stimulus consisted of black and white checkerboards with a visual angle of 8 degrees (central stimulus) and a global field with a 5 degrees central circular scotoma (peripheral stimulus), contrast level of 15%, and a frequency of 0.7 Hz. One hundred PVEP responses were averaged per session. We reported that there was a linear relation between log subjective visual acuity of 0.1-1.0 and log check size of the patterns with PVEP. In reference to that, the check sizes of the patterns were estimated at 66' with visual acuity of 0.05, and 107' with visual acuity of 0.01. Each visual acuity was then used with other check sizes of three patterns. RESULTS: With central stimulus the P100 components of O1, O2, and Oz were recorded with 66' and 82' patterns at visual acuity of 0.05(central stimulus). The P100 components of O1, O2, and Oz were 107', 137' and 161' at visual acuity of 0.01(central stimulus). There was no P100 component at visual acuity of 0.05 and 0.01(peripheral stimulus). CONCLUSION: This method of PVEP is a useful tool as an objective estimation of visual acuity less than 0.1 and is presumed to stimulate preferentially the X retinal ganglion cell to parvocellular pathway.     

PVEP in Patients with Different Types of Congenital Cataract

The preoperative and postoperative PVEP in 79 eyes of 45 patients with three types of congenital namely lamellar cataract, nuclear cataract and total cataract was studied. The results showed that visual acuity of patients who could be cooperatively examined was improved significantly after operation. The examination of PVEP revealed that more abnormal wave-formes were found in total cataract group before operation. P1 latencies of low and medium spatial frequencies (140‘, 70‘, and 35‘) became much longe...