老年黄斑变性的闪烁光和明视视网膜电图

对45眼干性型和24眼湿性型老年黄斑变性（AMD）作30Hz刺激频率闪烁光和明视ERG检测，闪烁光ERG波形经傅里叶变换后取基波（30Hz）的相位和幅值作为特征性指标进行观察。结果干性型AMD闪烁光ERG基波相位、幅值，明视红、白光b波幅值的异常率分别为48.89%、8.89%、8.89%及10.11%，异常率间有显著差异（P＜0.01）。视力正常的早期AMD中，基波相位仍有较高的异常率。湿性型AMD的基波相位与幅值的异常分别为62.50%和45.84%.两型AMD基波幅值、明视ERGb波幅值间有显著差异（P＜0.01）.表明幅值异常与病变程度有关，基波相位是检测AMD早期视功能变化的较敏感指标。 （中华眼底病杂志，1996，12：41-43）     

多焦视网膜电图评价视网膜脱离的视网膜功能

目的 探讨多焦视网膜电图(multifocal electroretinography, MERG)对视网膜脱离(retina detachment, RD)的视功能客观评价意义。 方法 应用VERIS 4.0视诱发反应图像系统检测21例RD患者的22只患眼和36例正常人的42只眼的MERG。测试野的水平视角为±26.6°,垂直视角为±22.1°,采用Burian-Allen接触镜电极,在8 min(分16段)记录103个视网膜部位的反应。 结果RD眼于4个象限、黄斑区和黄斑外区MERG a波、b波潜伏期及b波振幅密度、振幅之和均明显低于正常对照组(P<0.01);脱离区、非脱离区和正常眼的 MERG b波振幅密度分别为(3.44±2.85)、(6.34±3.31)、(21.32±6.48)nV/deg²,三者之间的差异均有非常显著性意义(P<0.05)。 结论 多焦ERG能客观定量评价RD的黄斑部、后极部的脱离区和非脱离区的视功能。(中华眼底病杂志,2000,16:244-247)     

视网膜脱离复位后的视网膜电流图分析

目的 应用视网膜电流图（ERG）了解孔源性视网膜脱离（RD）复位术后的视功能状态。方法 选择孔源性RD患者73例（73只眼），均进行单次巩膜扣带术，术前及术后不同时期分别检测ERG，随访1－5月。结果 视网膜脱离后，ERG各指标振幅明显下降，潜伏期延迟。手术后1月，ERG的a波、b波振幅较术前明显回升，潜伏期在术后均延迟。随复位时间的延长，振幅无明显变化，潜伏期有缩短趋势。视网膜脱离复位后，最大反应振幅b/a比值呈增加趋势。术后1月，暗视视杆细胞反应振幅可恢复至对照组的58.11%，30Hz闪烁光反应的振幅则恢复至对照组的45．89％。结论 视网膜脱离复位后视功能在1－2月内恢复最快且程度较大，视网膜内核层的恢复较光感受器层迅速，视杆系统较视锥系统恢复迅速且较完全，但随复位时间的延长增进缓慢。ERG的不完全的恢复表明视网膜仍存在不可逆的损害。     

视网膜脱离手术复位后ERG的恢复

为探讨视网膜脱离手术复位后ERG的改变，对35例（35眼）患者进行手术前后ERG检测，结果表明；（1）视网膜脱离术前ERGa、b波幅明显低于有视网膜格子样变性而无脱离者。（2）手术复位后ERGa、b波幅随时间延长逐渐回升。（3）视网膜脱离范围二个象限以内者ERGa、b波幅回升高于二象限以上者。（4）手术范围一个象限以内者与超过一个象限者相比前者ERG恢复优于后者。（5）视网膜脱离时间2月以内与超过2月相比，ERG恢复前者明显优于后者。结果证实视网膜脱离术后ERG恢复与手术后时间、脱离范围、病程及手术范围密切相关。     

视网膜电图对视网膜脱离术后效果的临床分析

目的 通过视网膜电图（electroretinogram,ERG)检测记录视网膜脱离（retinal detachment,RD）术后效果的分析，进一步了解RD光感受器细胞与第二级神经元功能异常的情况，并对ERG与视功能预后的关系进行探讨。方法 139例146眼RD患者检测其ERG，通过散大瞳孔直视眼底监控固视状态，记录分析a波，b波与振荡电位（oscillatory potentials,OPs)各顶成分。结果 与对照组相比16．00％，16．00%，10．00％，1－2周组为35．00％，45．00％，50．00％；2－4周组为46．80％，56．25％，62．50％；4－8周为76．00％，84．00％，88．00％；8周以上组则为86．96％，91．30％，95．65％。a波与b波在脱离时间＜1周组与对照组无明显差异，1－2周组a波与b波开始有明显降低（P＜0．05），随着发病时间的不断延长,b波的下降较a波更为迅速，2－4周则具有显著意义（P＜0．01）；b/a值在早期RD病变表现正常或轻度异常，伴随病程增加有降低趋势，4－8周即出现显著性降低（P＜0．05）。结论 ERG对RD眼黄斑功能异常的客观定位诊断对视功能预后有一定临床意义。     

早期糖尿病视网膜病变的视网膜电图研究

目的：研究早期糖尿病视网膜病变（diabeticretinopathy,DR) 的视网膜电图震荡电位（Oscillatory potentials,OPs)和图形视网膜电图（Pettern electroretinogram,P-ERG)的变化特点,借以早期诊断DR。方法：对20例（40眼）正常和50例（113眼）糖尿病病人进行OPs和P－ERG检测。结果：当糖尿病病人眼底尚未出现改变时,P－ERG的b波波幅和OPs各子波波幅及总波幅已降低。随着DR的发展,各参数的异常率逐渐上升,各波波幅也随之下降,潜伏期延长。OPs的O3波波幅和总波幅以及P－ERG的b波波幅较其它指标具有较高的敏感性,其中O3波波幅为最敏感的指标。结论：OPs的O3波波幅和总波幅等参数能够作为视觉电生理的功能性指标预测DR的发生,在DR的早期诊断和评价DM的疗效方面有临床应用价值。     

视网膜脱离眼的黄斑局部视网膜电图

目的：通过对视网膜脱离（retinal detachment,RD）眼的局部视网膜电图（local electroretinogram,LERG)记录分析,进一步了解RD眼黄斑部光感受器细胞与第二级神经元功能异常的情况,并对LERG与视功能预后的关系进行探讨。方法：120例RD患者128只眼的LERG被记录分析,应用手提眼底镜式局部刺激器通过放大的瞳孔直视眼底监控固视状况,记录a波、b波与OPs各项成分。结果：与对照组相比,LERG的a波、b波与OPs的异常率：在＜1周组分别为15%、15%与10%;在1-2周组为35%、45%与50%;在2-4周组为46.86%、56.25%与62.5%;在4-8周组为76%、84%与88%;在8周以上组则为86.96%、91.30%与95.56%。a波与b波在脱离时间＜1周组与对照组无明显差异;1-2周组a波与b波开始开始有明显降低（P＜0.05),随着发病时间的延迟,b波的下降较a波更为迅速,在2-4周则具有高度显著意义（P＜0.05)。b/a值在早期RP病变表现正常或轻度异常,伴随病程增加有降低趋势,在4-8周组即出现显著性降低（P＜0.05)。在眼底镜下黄斑部脱离的48只眼中,LERG各项成分的降低均有统计学意义;而在眼底镜下观测不到黄斑脱离的80只眼中,b波、OPs与OP2子波振幅也表现异常（P＜0.05)。结论：⑴在视网膜脱离眼,黄斑部光感受器与第二级神经元细胞的功能损害同时存在;⑵b波与a波的比值变化表明了内层与外层的相对损害程度,随着病情的发展,视网膜内层的损害有加重趋势;⑶RD伴黄斑脱离者的视网膜内外层功能受损程度明显增加,而镜下未脱离者也可存在功能的损害;⑷RD眼的OPs振幅可为视网膜内层循环功能的损害提供敏感性指标。研究认为：LERG对RD眼黄斑功能异常的客观定位诊断与视功能预后具有特定的临床意义。     

Muller细胞在增殖性糖尿病性视网膜病变中的作用

目的 评价Muller细胞在糖尿病性视网膜病变(DR)视网膜新生血管形成中的作用.方法 对239例(478只眼)非增殖期、增殖前期及早期增殖期DR病人进行了闪光视网膜电图(ERG)、局部ERG以及12、32、40赫兹闪烁光ERG检查,并计算纤维指数:闪光ERG的b波幅值/12赫兹闪烁光ERG幅值.此外,对37例增殖前期DR病人每间隔2～4个月进行动态电生理观察1～1.5年.结果 非增殖期DR的32、40赫兹闪烁光ERG b波幅值位于正常低限,闪光ERG的a波幅值中度降低,为(54±9.6)μv,b波幅值正常;12赫兹闪烁光ERG幅值明显降低,为(25.8±9.4)μv,纤维指数平均为(9.3±1.4)单位.增殖前期DR的所有视网膜电反应均中度下降,闪光ERG的b波幅值为(179±19)μv,12赫兹闪烁光ERG幅值为(13.0±6.4)μv,纤维指数为10～16单位,平均(13.8±1.3)单位,有极显著增高(P<0.001).早期增殖期DR的闪光视网膜电图的a波和32、40赫兹闪烁光视网膜电图幅值继续下降,分别为(30.0±12.2)μv、(8.8±2.7)μv和(4.o±2.1)μv,纤维指数平均为:(13.5±2.2),有极显著增高(P<0.001).动态观察表明,原来增高的纤维指数突然下降,说明近期出现视网膜新生血管的可能性极大.结论 纤维指数增高是视网膜缺血缺氧的共同特点,表明Muller细胞的代谢活性代偿性增高,证实其在视网膜新生血管形成中起重要作用.     

视网膜脱离术后多焦视网膜电图的变化

视网膜脱离（retina detachment，RD）是眼科常见的急性致盲性疾病之一。目前RD的主要治疗方法是手术封闭裂孔使视网膜尽快从解剖上复位，并使其功能得到一定的恢复。以往对脱离的视网膜手术前后的功能评价多采用全视野视网膜电图（eletroretinogram，ERG），而其反映的是整个视网膜的功能，但实际视网膜脱离范围可能只局限于1～3个象限，故ERG不能准确地反映脱离区视网膜手术前后的功能变化。多焦视网膜电图（multifocal electroretinogram，mfERG）弥补了这一空缺，其可客观检测不同区域的实际视网膜功能，较准确地反映视网膜功能变化。本组对16例RD患者的16眼术前和术后1个月行mfERG检查，以评价脱离的视网膜复位后视功能改善情况。     

正常Wistar大鼠多焦视网膜电图特性

目的:探讨正常Wistar大鼠的多焦视网膜电图(mfERG)特性。方法:正常Wistar大鼠7只,在暗适应5h以上,采用RETscan3.15系统检查一侧眼的mfERG。为避免记录时间和麻醉药物的可能影响,每次记录间隔3d。结果:注视点位于屏幕中心,当刺激图形为黑白交替时,mfERG总和反应P1波的潜伏期为(44.14±1.35)ms,幅值为(79.71±9.15)μV,上半野的P1波反应密度、P1波幅值和N1波幅值高于下半视野(P<0.05),P1波反应密度、P1波幅值和N1波幅值随离心度的增加而减少(P<0.05)。重复记录结果没有显著性差异(P>0.05)。结论:通过mfERG方法可以反映部分视网膜的功能,我们可靠地记录Wistar大鼠视网膜mfERG的正常特征,为进一步实验奠定了基础。     

Predominant loss of the photopic negative response in central retinal artery occlusion

PURPOSE: To determine how the photopic negative response (PhNR) is affected in central retinal artery occlusion (CRAO). DESIGN: Observational case series. METHODS: Seven patients with unilateral CRAO were included. Full-field scotopic and photopic electroretinograms (ERGs) including the PhNR were recorded. Each ERG amplitude in the affected eye was expressed as a percentage of amplitude of the corresponding wave in the unaffected eye. RESULTS: Mean of the PhNR amplitude was reduced to 12.3 +/- 11.7% of that of unaffected eyes whereas the cone b-wave amplitude was attenuated to only 73.4 +/- 30.4%. This reduction of the PhNR amplitude was more significant than that of other waves including the rod b-wave, maximum a-wave and b-wave, cone a-wave and b-wave, and 30 Hz flicker ERG (P <.005). CONCLUSIONS: The PhNR was severely affected in CRAO despite relative preservation of the cone b-wave, implicating massive loss of ganglion cells and their axons.     

视网膜中央静脉阻塞性黄斑水肿的OCT与ERG的对比分析

目的：观察视网膜中央静脉阻塞性黄斑水肿的黄斑区视网膜厚度与视网膜电图( electroretinogram, ERG )各项参数(Cone-a,Cone-b和30Hz)变化的关系。
　　方法：随机选择视网膜中央静脉阻塞患者25例25眼及25只对侧眼分别行明视闪光视网膜电图及光学相干断层扫描( optical coherence tomography,OCT)检查,明视闪光视网膜电图检查测各项参数的振幅和潜伏期, OCT测量黄斑区九部分的视网膜厚度,分析黄斑区形态参数与明视闪光视网膜电图各参数变化之间的关系。
　　结果：黄斑区除颞侧外七个部位视网膜厚度与 ERG 的Cone-b和30 Hz潜伏期相关。
　　结论：研究发现视网膜中央静脉阻塞患者的黄斑区视网膜厚度与内层视网膜功能密切相关。     

Vigabatrin: longterm follow-up of electrophysiology and visual field examinations

BACKGROUND: To report the results of repeated electrophysiological and visual field examinations in patients with vigabatrin-associated visual field loss (VGB-VFL) and the relationship between these electrophysiological findings, the cumulative dose of vigabatrin and the extent of visual field loss. METHODS: Twenty-two eyes of 11 patients with VGB-VFL were studied. All patients underwent surgery for therapy-resistant epilepsy. Repeated electro-oculograms (EOGs) and flash electroretinograms (ERGs) were made and the cumulative dose of vigabatrin and the visual field loss were recorded after a period of 37-47 months. RESULTS: The visual field loss was stable in patients who had stopped vigabatrin at the time of the first examination. There was a slight increase in VFL in patients who continued vigabatrin. During the second EOG and ERG, abnormalities in scotopic and photopic a-wave latencies and in scotopic b-wave amplitude were found in more than 50% of patients. Only b-wave latency became normal, while EOG, a-wave latency, a-wave amplitude and b-wave amplitude stayed abnormal. The amount of VFL and the cumulative dose of vigabatrin were statistically correlated with the b-wave amplitude, mainly photopic, found during the first and second examinations. CONCLUSION: After 4 years, EOG, flash ERG and visual field loss had not improved in patients with VGB-VFL. The statistically significant correlation found during the first examination between the amount of VFL and the cumulative dose of vigabatrin with the (mainly photopic) b-wave amplitude remained constant.     

Differential light perception threshold of the visual field and ERG following operatively attached retinal detachment

After surgical treatment of retinal detachment with a spontaneously pigmented demarcation line the visual fields of twelve patients were tested. The increment threshold of all positions (determined with the Octopus automatic perimeter system) was compared with the reduction in the scotopic and photopic ERG amplitudes (determinated with the CEMIDA system). This reduction in the ERG amplitudes was evaluated using the difference between the amplitude of the ERG waves of the eye with cured retinal detachment and of the healthy fellow eye. No great correlation between the two parameters was found, but it appeared that a reduced mean increment threshold correlated with a reduction in the a-wave amplitude.     

Abnormalities of the photoreceptor-bipolar cell synapse in a substrain of C57BL/10 mice

PURPOSE: A preferential loss of ERG b-wave was detected in a substrain of C57BL/10 mice. Electroretinographic and histologic techniques were used to investigate this hitherto unknown retinopathy. METHODS: ERGs were obtained from normal and affected C57BL/10. C57BL/6 mice served also as controls. a-Wave and c-wave analyses were performed. Microscopic investigations were done at two different ages. RESULTS: In the scotopic ERG, a severe reduction of the b-wave amplitude could be observed, whereas the a-wave was only moderately attenuated ("negative ERG"). With age, the a-wave amplitude further decreased, but the rate of reduction was comparable to normals. Oscillatory potentials were severely altered, and the photopic ERG was absent. The ERG c-wave was comparable to normal. ERG a-wave analysis also revealed a reduced maximum amplitude, but no significant difference of receptor sensitivity. Light microscopy revealed a thinning of all retinal layers but mostly of the outer plexiform layer. The number of photoreceptor nuclei was reduced by one third. Electron microscopy revealed a profound loss of ribbon-shaped synapses between rod and rod-bipolar cells and severely abnormal ribbons in the case of cones. CONCLUSIONS: The so-called negative ERG was associated with alterations in the synaptic layer between rods and rod bipolars. The absent cone ERG may be due to the altered cone-on-bipolar synapses. The overall thinning of the retina as well as the moderately reduced scotopic a-wave amplitude remain unexplained.     

Analysis of photoreceptor function and inner retinal activity in juvenile X-linked retinoschisis

Thirteen retinoschisis males with genotyped XLRS1 gene mutations were examined by electroretinogram (ERG) techniques to determine photoreceptor involvement and ON-pathway and OFF-pathway sites of dysfunction. Parameters R(max) and logS determined by fitting the mathematical model of the activation phase of phototransduction to the scotopic and photopic a-wave responses, were not significantly different from normal. However, the XLRS photopic a-wave amplitudes were significantly lower than normal across all intensities, consistent with defective signaling in the OFF pathway. Long flash (150 ms) ON-OFF photopic responses showed reduced b-wave amplitude but normal d-wave amplitude, giving a reduced b/d ratio of <1.32 Hz photopic flicker ERG fundamental frequency responses showed reduced amplitude and delayed phase, consistent with abnormal signaling by both the ON- and OFF-pathway components. These results indicate that the XLRS1 protein appears not to affect photoreceptor function directly for most XLRS males, and that ERG signaling abnormalities occur in both the ON- and OFF-pathway components that originate in the proximal retina.     

Alteration of electroretinographic recordings when performed under sedation or halogenate anesthesia in a pediatric population

Fran The effects of sedation and of halogenate anesthesia on electroretinographic recordings were investigated by reviewing the hospital charts of 27 patients who were eventually diagnosed free of retinal disease. The same ERG protocol was performed in conscious (n=9), sedated (chloral hydrate or pentobarbital sodium, n=9) and anesthetized (halothane or isoflurane, in combination with N2O, n=9) young patients. Sedation decreased the a- and b-wave amplitude of the scotopic bright-flash response, without affecting implicit times. ERG recordings performed in photopic conditions showed minimal disturbances. Anesthesia spared the a-wave of the scotopic bright-flash response but decreased more severely the b-wave. In addition, anesthesia reduced the amplitude and prolonged the implicit time of the photopic responses, affecting predominantly the ionotropic glutamate dependent OFF components (peak of b-wave, 0P4 and 0P5). The normal retinal physiology is affected by sedation and anesthesia through different mechanisms that still remain to be fully elucidated. These alterations in electroretinographic recordings must be considered when evaluating ERGs obtained under similar sedation/anesthetized conditions.     

Selective abnormality of the cone B-wave in a patient with retinal degeneration

A 44-year-old woman with midperipheral pigmentary changes that resemble retinitis pigmentosa (RP) is described; unlike typical patients with RP, her photopic b-wave was markedly attenuated as compared with her photopic a-wave. Otherwise, her electroretinogram (ERG) was typical of patients with early stages of photoreceptor degeneration. Scotopic and photopic a-wave amplitudes were reduced about 50%; her scotopic b/a appeared normal.     

Electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in age related macular degeneration

AIM: To evaluate electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in patients with age related macular degeneration (AMD). METHODS: A consecutive series of 32 patients suffering from subfoveal choroidal neovascularisation secondary to AMD underwent 360 degrees retinotomy and macular translocation. The ERG served as the main parameter of the study and was recorded 1 day before the translocation surgery and no earlier than 4 weeks after the silicone oil removal. RESULTS: The scotopic ERG amplitudes were significantly reduced after translocation surgery. Depending on the applied flash luminance the mean b-wave amplitude reduction of the scotopic ERG varied between 67% (0.2 cd.s/m2) and 74% (0.03 cd.s/m2). The a-waves and b-waves of the saturating light response decreased significantly by 46% and 59%, respectively. The photopic a-wave and b-wave amplitudes were significantly lower after the translocation surgery resulting in a mean reduction of 27% and 43%, respectively. CONCLUSIONS: Although macular translocation may provide the potential of preserving and even restoring vision in patients with subfoveal choroidal neovascular membranes secondary to AMD the present study indicates that a significant electrophysiological decrease is caused by surgical procedures associated with this technique. Further research is necessary to clarify if certain modifications of the surgical procedure are able to substantially reduce the neuroretinal trauma.