高度近视眼黄斑部视网膜厚度及多焦视网膜电图的测定分析

目的检测高度近视眼屈光度数、眼轴长度、黄斑中心凹视网膜神经上皮层厚度及多焦视网膜电图（multifocal electroretinography,mfERG）各波的反应密度与潜伏期,并与正常人比较,评价其差异。方法选择高度近视患者30例（30眼）和正常对照组30例（30眼）,用A超测量眼轴长度,光学相干断层扫描仪（optical coherence tomography,OCT）测量黄斑中心凹神经上皮层厚度,mfERG检测黄斑部视网膜电图各波反应密度及潜伏期,分析高度近视眼屈光度数、眼轴长度、中心凹部神经上皮层厚度及mfERG各波的反应密度、潜伏期。结果高度近视眼平均眼轴长为（28.10±2.67）mm,与对照组比较,差异有统计学意义;黄斑中心凹平均神经上皮层厚度为（163.67±4.93）μm,与对照组比较,差异无统计学意义;黄斑部mfERG反应密度N1波为（18.26±4.95）nV/deg2,P1波为（30.97±10.58）nV/deg2,N2波为（23.66±9.03）nV/deg2,同正常值相比,各波反应密度显著下降,潜伏期差异无统计学意义。结论高度近视眼与正常眼相比,眼轴增长,但黄斑区神经上皮层厚度尚未有明显改变。黄斑部mERG各波反应密度皆降低,提示视网膜感光细胞功能下降。     

累及黄斑的孔源性视网膜脱离手术前后黄斑区光学相干断层扫描与多焦视网膜电图的变化

目的：观察累及黄斑区的孔源性视网膜脱离( RRD)患眼手术前后黄斑区光学相干断层扫描(OCT)与多焦视网膜电图（mfERG）表现的变化。 方法：回顾性研究。选择2013年9月至2014年7月在河南省眼科研究所确诊为累及黄斑的RRD并行巩膜扣带术的患者52例（52眼）,以对侧正常眼作对照。RRD患眼均行巩膜扣带手术治疗。手术前及手术后1周,术后1、3、6个月,进行OCT及mfERG检查,观察RRD患眼黄斑区微结构,以及黄斑区反应振幅密度及潜伏期的变化。采用t检验对术前患眼与正常眼进行比较,采用重复测景方差分析对患眼手术前后黄斑中心凹厚度变化与中央1环的N1、P1波反应密度和潜伏期比较分析;采用Pearson积矩相关分析法分析术后各时问点最佳矫正视力(BCVA)与黄斑中心凹厚度、中央1环的N1、P1波反应密度和潜伏期的相关性。 结果：所有患眼术后均成功复位。术前患眼黄斑中心凹厚度较正常眼明显增厚,为(534+44) μm,差异有统计学意义（t=17.127,P<0.05）,术后1周、1个月、3个月、6个月患者黄斑中心凹厚度,较术前明显降低,差异有统计学意义(P<0.01)。与正常眼相比较,术前患者中央1环Nl波和P1波振幅密度降低（t_N1=17.372、t_p1=23.943,P< 0.05）,潜伏期延长（t_Nl=5.291、t_Pl=7.306,P< 0.05）,差异均有统计学意义,术后1周、术后1、3、6个月中央1环N1波及P1波振幅密度较术前均提高（P<0.01）,潜伏期与术前差异无统计学意义。患者BCVA在术后1、3、6个月与黄斑中心凹厚度呈负相关(r=-0.801、-0.695、-0.643,P<0.05),l与中央1环N1波及P1波振幅密度呈正相关(r_N1=0.702、0.695、0.632,r_p1=0.811、0.713、0.648;P< 0.05),与潜伏期无相关性。 结论：OCT与mfERG可以客观综合观察RRD患者术后黄斑区的形态和功能,评估视网膜脱离后的手术疗效。     

视网膜静脉阻塞的黄斑区视网膜厚度与多焦视网膜电图分析

目的观察视网膜静脉阻塞的黄斑区厚度与多焦视网膜电图(multifocal electroretinogram,mf-ERG)变化的关系。方法随机选择视网膜静脉阻塞患者36例(37只眼),分别行多焦视网膜电图及光学相干断层扫描(optical coherence tomography,OCT)检查,多焦视网膜电图选取中央4环内(约13°),分为黄斑中心凹及其上方、下方、颞侧和鼻侧共5部分,与OCT视网膜厚度分析相对应。结果黄斑各部位视网膜厚度与mf-ERG各波反应密度负相关,与潜伏期呈正相关,且与潜伏期相关程度较高。其中中心凹及其鼻侧、下方与各波的相关性较好。结论mf-ERG与OCT相结合能更好显示视网膜静脉阻塞眼受损状况,其黄斑区形态与功能改变不完全一致,与部位有关,中心凹及其鼻侧、下方厚度改变对mf-ERG各波影响相对较明显。N1波潜伏期是较好的观察指标。     

多焦视网膜电图对外伤性黄斑裂孔手术前后视功能的评价

目的应用多焦视网膜电图（mfERG）研究外伤性黄斑裂孔手术前后视网膜功能,探讨外伤性黄斑裂孔视功能损害机制,为治疗及手术方法的选择与改进、预后的评估提供参考。方法应用VERIS science^TM4.2多焦电生理系统对23例（23只眼）外伤性黄斑裂孔眼手术前、后进行mfERG检测,以mfERG一阶反应N1波、P1波的振幅密度、潜时为分析指标,对不同视网膜区域包括六个离心度,中心凹、黄斑区、黄斑外区进行检测。对视力与mfERG的关系进行分析。结果外伤性黄斑裂孔手术前后的mfERG比较：黄斑裂孔术后N1、P1波振幅密度较术前提高,只有N1波在黄斑区的差异有统计学意义（P〈0.05）;术后中心凹处潜时延长,黄斑区潜时缩短,只有N1波在中心凹的差异有统计学意义（P〈0.05）。黄斑裂孔术后视力与mfERG反应密度的相关分析,二者存在正向相关rs=0.735,P=0.015。结论 mfERG能对外伤性黄斑裂孔眼视网膜功能进行定位定量测量。     

无黄斑水肿的NPDR患者中心凹区mfERG与视网膜厚度的研究

目的：分析非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)无黄斑水肿的患者黄斑中心凹区视网膜功能及厚度间的关系。

方法：选取NPDR患者20例35眼患眼为糖尿病视网膜病变(diabetic retinopathy,DR)组,行多焦视网膜电图(multifocal electronic retinography, mfERG)及Spectralis 相干断层扫描(Spectralis optical coherence tomography,Spectralis OCT)检查。以15例20眼正常眼为OCT对照组,以19例20眼正常眼为mfERG对照组,OCT对照组做Spectralis OCT检查,mfERG对照组做mfERG检查。

结果：与对照组相比,DR组黄斑中心凹mfERG1环的P1波反应密度减小,P1波及N1波隐含期改变无统计学意义; DR组无水肿的黄斑中心凹视网膜厚度、神经上皮层厚度仍有显著增加。

结论：应用mfERG可以在视网膜无可见明显结构改变之前发现视网膜功能上的异常变化; Spectralis OCT可以测量视网膜各层厚度,反映视网膜精细结构变化,验证视网膜功能上的异常改变,二者联合应用为极早期发现糖尿病视网膜病变视功能改变提供有效的证据,并为及时治疗提供资料。     

全视网膜光凝治疗糖尿病视网膜病变后黄斑区视功能的评价

目的 探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜光凝(panretinal photocoagulation,PRP)治疗后黄斑区视功能的变化及其与黄斑形态改变的相关性.方法 选取DR患者24例(41眼),行PRP治疗后随访3个月,对比分析患者PRP治疗前后患眼的中心视力,多焦视网膜电图(multifocal electroretinography,mfERG)和光学相干断层扫描(optical coherence tomography,OCT)检测黄斑区视功能的变化与黄斑形态改变,探讨PRP治疗后黄斑区视功能的变化及其与黄斑形态改变的相关性.结果 DR患者PRP治疗后3个月的中心视力和黄斑中心凹厚度分别为0.52 ±0.28、(257.55±124.30)μm,与治疗前的0.57±0.32、(241.15±103.43)μm相比,差异均无统计学意义(t=1.27,P=0.22;t=-1.00,P=0.33).mfERG N波4、5环及P1波3、5环的反应密度较PRP治疗前明显降低,差异均有统计学意义(t=2.48、3.69、2.23、2.40,均为P<0.05),但各波潜伏期相比差异均无统计学意叉(均为P>0.05);黄斑中心凹厚度与mfERG的测量结果无相关性(均为P>0.05).结论 PRP治疗虽然没有引起DR患者中心视力及视网膜厚度的变化,但导致了邻近未接受光凝区域的视网膜功能障碍,表现为mfERG反应密度的降低.     

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。     

视网膜静脉阻塞黄斑水肿的多焦视网膜电图特点

目的 研究视网膜静脉阻塞黄斑水肿(RVO-ME)多焦视网膜电图(mfERG)的特点.方法 横断面研究.筛选视网膜静脉阻塞黄斑水肿的患者39例(39只眼),采用多焦视网膜电图评估患者视功能(P1波振幅密度、P1波峰时、环反应比值),采用相干光层析成像术(OCT)及OCTA检测视网膜结构(视网膜厚度、椭圆体带的连续性、有无...     

光动力疗法治疗病理性近视CNV前后mfERG的变化

目的采用多焦视网膜电图（multifocal electroretinogram,mfERG）动态观察病理性近视合并脉络膜新生血管（choroidal neovascularisation,CNV）患眼光动力疗法（photodynamic therapy,PDT）治疗后早期视网膜功能的改变。方法经FFA/ICGA、OCT检查确诊的继发于病理性近视黄斑下活动性CNV患者30例（30眼）行PDT治疗,分别在治疗前及治疗后1周、1个月和3个月行mfERG检查,并与未行PDT治疗的对照组12例（13眼）进行同期的对比分析。结果治疗组PDT治疗后不同时间点与治疗前反应密度值比较：治疗后1周、1个月和3个月mfERG3-5环N1波、3-5环不等P1波振幅密度值比治疗前明显提高（P〈0.05）;治疗组与对照组组间同期反应密度值比较：治疗前两组组间同期反应密度值和潜伏期的比较无显著统计学差异（P〉0.05）。1周后3环、5环N1波和5环、6环P1波振幅密度值比对照组明显提高（P〈0.05）,1个月后3-5环N1波、4-5环P1波振幅密度值比对照组明显提高（P〈0.05）,3个月后3-5环N1波、4-5环P1波振幅密度值比对照组明显提高（P〈0.05）。结论mfERG一阶反应的振幅密度值反映了PDT治疗对于稳定CNV患眼黄斑区视网膜功能及改善CNV患眼黄斑中心凹旁的视功能具有一定的意义。     

特发性黄斑裂孔手术前后的视力、多焦视网膜电图及光相干断层扫描的变化分析

目的 观察并分析特发性黄斑裂孔（IMH）患者手术前后的视力、多焦视网膜电图（mfERG）及光相干断层扫描（OCT）的变化特征，评估黄斑裂孔手术 疗效。 方法 收集2001年2月～2002年5月在我院行玻璃体切割术治疗IMH 的患者28例（28只眼），分别在手术前和手术后1、3、6、12个月时，对患者行视力、mfERG及OCT检查，并与正常对照组（33只眼）进行比较，对结果进行统计分析。 结果 （1）OCT显示手术后1个月内27只眼（96.43%）黄斑裂孔完全闭合，1年内无复发，1只眼（3.57%）1年内黄斑裂孔始终未闭合。（2）IMH眼手术后1年视力较手术前明显提高（P＜0.01），视力恢复主要在手术后6个月内。（3）IMH眼手术前mfERG一阶函数的1环和2环P1波反应密度明显降低，典型三维地形图呈火山口样改变。手术后1年mfERG一阶函数的1环和2环P1波反应密度不断增加，持续到1年以后，三维地形图表现为中央峰逐渐恢复。手术后12个月时，1环和2环P1波反应密度较手术前明显增加（P＜0.05），但仍然低于正常对照组（P＜0.05）；而3、4、5环P1波反应密度始终未受明显影响（P＞0.05）。（4）27只眼手术后黄斑裂孔完全闭合后，经OCT测量的黄斑中心凹的视网膜神经上皮层（FRNEL）厚度在手术后1～12个月维持不变，且始终低于正常对照组（P＜0.01）。（5）IMH眼手术后12个月时，视力、mfERG一阶函数1环和2环的P1波反应密度、FRNEL之间均呈正相关关系（P＜0.05）。 结论 玻璃体切割术是治疗IMH的有效 方法，视力、mfERG及OCT可以很好地评估黄斑裂孔的手术疗效，且三者间总体上具有一致性 。 （中华眼底病杂志，2004，20：221-225）     

Correlation between functional and anatomical assessments by multifocal electroretinography and optical coherence tomography in central serous chorioretinopathy

To evaluate the correlation between functional and anatomical assessments with multifocal electroretinography (mfERG) and optical coherence tomography (OCT) in patients with acute central serous chorioretinopathy (CSC). Thirty-four eyes of 34 patients with acute CSC underwent mfERG and OCT examinations. First-order mfERG N1 and P1 response amplitudes and latencies were analyzed. OCT parameters measured included central subretinal fluid (SRF) thickness, central retinal thickness, total central foveal thickness, vertical, and horizontal diameters of SRF, and macular volume. Correlation analyses were performed between best-corrected visual acuity (BCVA), mfERG parameters, and OCT measurements. Correlation analysis showed that logMAR BCVA was significantly correlated with mfERG N1 amplitudes of rings 1 and 2 (P = 0.006), N1 latency of ring 4 (P = 0.012), and P1 latency of ring 1 (P = 0.036). No significant correlation was observed between logMAR BCVA and any of the OCT measurements. For the correlation between mfERG parameters and OCT measurements, mfERG N1 and P1 latencies of the paracentral rings were significantly correlated with the central SRF thickness (P ≤ 0.024), diameters of the SRF (P ≤ 0.018), and macular volume (P ≤ 0.030). MfERG responses but not OCT measurements correlated with logMAR BCVA in patients with acute CSC. The amount of SRF nonetheless correlated with the mfERG N1 and P1 latencies of the paracentral rings, suggesting that impairment in the conduction of electrical responses in the paracentral macula is proportional to the severity of serous macular detachment in CSC. MfERG and OCT can complement each other in the functional and anatomical assessments in CSC.     

In diabetic retinopathy, foveal thickness of 300 μm seems to correlate with functionally significant loss of vision

Purpose To study the relationship between foveal thickness assessed by optical coherence tomography (OCT) and foveal function measured with multi focal electroretinography (mfERG) in patients with non-proliferative diabetic retinopathy, and with no previous laser treatment. Methods Twenty-six eyes from 18 diabetic patients (13 men), aged 59 years, (range 28–79 years), diabetes duration 15 years, (range 2–27 years), with a macular thickness between 200 and 600 μm were evaluated by mfERG, visual acuity (ETDRS score) and OCT. Mean amplitudes and implicit times of the mfERG responses were analyzed within the four innermost (14 degrees) of the six concentric rings. For comparison with the results from the OCT (diameter of measured area = 6 mm) we analyzed the summed response from the first and second ring (central zone), corresponding to the central area of the OCT. The third(zone 2) and fourth (zone 3)of the four innermost of the six concentric rings measured by the mfERG corresponding to the second and third area of OCT. Results An increased macular thickness in the central area of the OCT correlated to reduced amplitudes (r = −0.541; P = 0.004) and prolonged implicit times (r = 0.548; P = 0.004) in the central zone of the mfERG, and inversely correlated with visual acuity, −0.49; P = 0.045. Retinal thickness in the second area was correlated to prolonged implicit times in the second mfERG zone (r = −0.416; P = 0.034). No correlations were found for the third area of the OCT. When macular thickness exceeded 300 μm the decrease of amplitudes and prolonged implicit times, measured by mfERG, seemed to be more pronounced. Conclusion In conclusion increased macular thickness is correlated with reduced amplitudes and prolonged implicit times on the mf ERG and worse visual acuity.     

Macular function assessed with mfERG before and after panretinal photocoagulation in patients with proliferative diabetic retinopathy

Purpose: To examine macular function and its correlation to macular thickness before and after panretinal photocoagulation for proliferative retinopathy in diabetic patients. Methods: Ten diabetic patients (aged 57 ± 10 years, diabetes duration 21 ± 10 years) treated with panretinal photocoagulation outside the great vascular arcade underwent multifocal electroretinography (mfERG) and optical coherence tomography (OCT) before and 6 months after treatment. When focal treatment in the macular region was performed prior to panretinal photocoagulation the investigations took place 3 weeks after this treatment but before the panretinal photocoagulation. One eye per patient was examined. Amplitudes and implicit times of the mfERG response were analyzed within the four innermost (27°) of the six concentric rings registered by the mfERG, which corresponds to the area measured by the OCT (Ø 3.5 mm). Results: Visual acuity was similar before and after photocoagulation, 1.0; 0.7–1.0 (md, range) versus 1.0; 0.6–1.0 (md, range). The mean values of the ring average amplitudes were reduced in the first and second, third and fourth concentric rings from foveola after photocoagulation, p= 0.001, p= 0.011 and p= 0.004, respectively. No change was seen in implicit time after treatment. OCT values were similar before and after photocoagulation. There was no correlation between retinal thickness assessed with OCT and amplitudes measured by the mfERG. Conclusion: In spite of unchanged values of retinal thickness and visual acuity, panretinal photocoagulation seems to cause a functional impairment in the adjacent untreated macula, shown by reduced amplitudes measured by the mfERG.     

频域光学相干断层扫描观察康柏西普治疗老年性黄斑变性患者黄斑结构的变化

目的　利用频域光学相干断层扫描（optical coherence tomography,OCT）观察湿性老年性黄斑变性（age-related macular degeneration,AMD）患者经康柏西普治疗后黄斑中心凹结构的变化并分析与最佳矫正视力（best corrected visual acuity,BCVA）的相关性。方法　经荧光素眼底血管造影确诊为湿性AMD的患者纳入研究,所有患者接受连续3个月、每个月玻璃体内注射一次康柏西普的常规疗法,记录治疗前及各次注射后1个月的BCVA以及频域OCT的特征（黄斑中心凹视网膜厚度、视网膜内积液、视网膜下积液、视网膜色素上皮层脱离、视网膜下纤维化等）。结果　经过3次注射治疗后,BCVA从治疗前的（0.98±0.55）LogMAR提高到治疗后的（0.69±0.43）LogMAR（P<0.01）,黄斑中心凹视网膜厚度从治疗前的（449.07±245.19）μm降低到治疗后的（232.76±103.93）μm（P<0.01）,其中初次注射后第1个月BCVA和黄斑中心凹视网膜厚度的改善最为明显;3次注射后视网膜内积液或视网膜下积液消退组BCVA改善并没有明显优于各自的未消退组（均为P>0.05）,但单纯视网膜下积液组BCVA明显优于单纯视网膜内积液组和混合积液组（F=6.168,P=0.007）。结论　频域OCT是一种评价黄斑结构改变的有效手段,为临床分析注射康柏西普术后视力的变化提供了有力的依据。     

Multifocal electroretinogram in normal emmetropic subjects: correlation with optical coherence tomography

Aim of the Study:

To establish the normative database for multifocal electroretinogram (mfERG) parameters in a normal emmetropic population. To correlate the data so obtained with the central macular thickness obtained using the optical coherence tomography (OCT) scan.

Materials and Methods:

mfERG data were obtained from 222 eyes of 111 emmetropic subjects. The amplitude (nv/deg²) and implicit times (ms) of the first-order kernel mfERG responses (N1, P1, and N2 waves) were obtained and grouped into five rings (Ring 1: Central 2°, Ring 2: 2–5°, Ring 3: 5–10°, Ring 4: 10–15°, Ring 5: >15°). The central macular thickness (CMT) was obtained using the macular thickness scan protocol of the OCT.

Results:

The mfERG data obtained were used to create a normative database. The amplitudes of the mfERG waves were maximum in the fovea and progressively decreased with increasing eccentricity (P = 0.0001). The latencies of the P1 and N2 waves were longest in the central ring and progressively shortened with eccentricity (P = 0.0001). No statistically significant correlations were observed between central ring 1 parameters and the CMT.

Conclusion:

This study establishes normative database for mfERG parameters in an emmetropic population. No statistically significant correlation was noted between CMT and mfERG parameters.     

Macular function by multifocal electroretinogram in diabetic macular edema after intravitreal triamcinolone acetonide injection

PURPOSE: The purpose of this study was to assess macular function by multifocal electroretinography (mfERG) in eyes with diabetic macular edema (DME) after intravitreal triamcinolone acetonide (IVTA) injection. METHODS: Fifteen eyes of 15 patients with DME scheduled for 4 mg IVTA injection were prospectively recruited. The response to treatment was monitored functionally by visual acuity (VA) measurement and mfERG and anatomically by foveal thickness measured by optical coherence tomography (OCT). The first-order kernel P1 mfERG responses from 0 to 7 degrees (central) and 7 to 25 degrees (peripheral) were grouped and analyzed. Changes in functional parameters (VAs and the P1 mfERG response amplitudes and peak latencies) and morphometric parameters (OCT foveal thickness) in eyes with DME 1 and 3 months after IVTA injection were compared with baseline values by Student t test. RESULTS: The mean baseline logMAR value for VAs of the patients before treatment was 0.49+/-0.26. After treatment, it was 0.27+/-0.23 at 1 month and 0.26+/-0.18 at 3 months, and differences from pretreatment values were significant (for each, p<0.001). There were statistically significant decreases in the mean foveal thickness at 1 and 3 months after treatment compared with pretreatment values (for each, p<0.001). There were also statistically significant increases in the mean P1 response amplitude for both central and peripheral groups at all examinations compared with pretreatment (for each, p<0.001). The mean P1 peak latencies for both the central and peripheral groups were shortened, but not significantly. CONCLUSIONS: As well as the reduction in DME and improvement in VA, IVTA injection improves macular function as assessed by mfERG in diabetic patients.     

两种光凝术治疗中心性浆液性脉络膜视网膜病变效果比较

目的:比较577 nm微脉冲激光与传统激光视网膜光凝治疗急性中心性浆液性脉络膜视网膜病变(CSC)的临床效果。方法:前瞻性临床随机对照研究。2017年7月至2018年6月郑州大学第一附属医院临床确诊的急性CSC 45例(54只眼)纳入本研究。患者随机分为两组,A组,23例(29只眼)进行577 nm微脉冲激光光凝,B组,22例(25只眼)进行传统激光光凝。随访观察两组治疗效果。结果:两组治疗后视力(BCVA)较治疗前均有提高(P<0.05);黄斑中心区厚度(CMT)及视网膜下液(SRF)均较治疗前降低(P<0.05)。但治疗前、治疗后1及3个月,两组之间BCVA、CMT及SRF比较差异均无统计学意义(P>0.05)。在末次随访中,A组眼底检查及OCT检查中均未发现激光斑或视网膜色素上皮损伤;而B组眼底检查中13只眼(52.00%,13/25)可见激光处脱色素改变或轻微色素上皮增生,OCT检查中6只眼(24.00%,6/25)可见局部视网膜色素上皮不规则样改变或缺损。结论:577 nm微脉冲激光及传统激光视网膜光凝治疗急性CSC均有效,可提高患者BCVA,降低CMT及SRF,但577 nm微脉冲激光损伤轻。     

中心性浆液性脉络膜视网膜病变光动力治疗后微视野的改变

目的 研究低剂量光动力治疗中心性浆液性脉络膜视网膜病变（CSC）患眼治疗前后与最佳矫正视力相比微视野计监测视网膜功能的作用。方法 前瞻性自身对照研究。收集2011年3月4日至2011年7月28日就诊于北京同仁眼科医院接受低剂量光动力治疗（PDT）的CSC患者34例（34眼）。在治疗前、治疗后3个月、6个月、12个月进行最佳矫正视力（BCVA）、光相干断层扫描（OCT）评价,治疗前、治疗后3个月进行微视野计中心12度和固视稳定性评价。对两种检查方法治疗前后的检查结果进行χ2检验,对治疗前后检查结果进行前后对照的单因素方差分析,对BCVA与微视野视网膜敏感度相关性进行线性相关分析检测。结果 治疗后12个月BCVA为（85.5±6.8）个字母,较治疗前的（78.1±6.9）个字母明显提高（t=78.05,P<0.01）。治疗后3个月微视野敏感性为（17.2±2.1）dB,较治疗前的（14.1±3.8）dB明显提高（t=19.28,P<0.01）。治疗后12个月OCT检测黄斑中心厚度为（239.2±21.0）μm,较治疗前的（432.7±142.5）μm明显减小（t=18.34,P<0.01）。治疗前和治疗后3个月BCVA的变化与微视野敏感度变化经Mann-Whitney秩和检验差异无显著统计学意义（Z=-1.191,P>0.05）。经线性相关检测,治疗前（r=0.5,P<0.05）、后（r=0.6,P<0.05）患眼BCVA结果与微视野平均敏感度相关,而OCT黄斑中心区厚度与微视野敏感度无相关性（r=0.01和0.002,P均>0.05）。结论 低剂量PDT治疗可以有效地提高CSC患眼的BCVA、促进黄斑区视网膜下液吸收,改善黄斑区视网膜敏感度。微视野黄斑区视网膜敏感度检查在辅助BCVA随访评价CSC患眼治疗后黄斑区视功能变化中有较好的作用。     

Structural and functional outcomes after treatment of uveitic macular oedema: an optical coherence tomography and multifocal electroretinogram study

Background: The aim was to evaluate the correlation between the anatomical and functional outcomes before and after treatment of uveitic macular oedema. Methods: Thirty‐three eyes of 33 patients with uveitic macular oedema were included in the present study. Visual acuity (VA), optical coherence tomography (OCT) and multifocal electroretinogram (mfERG) were measured before and after treatment of the macular oedema. Correlation analyses between VA, OCT and mfERG parameters were performed. Results: The VA and mfERG measurements showed statistically significant improvement after treatment of the macular oedema (p < 0.01) and OCT‐measured central foveal thickness decreased significantly from 434 ± 135 µm before treatment to 267 ± 92 µm after treatment (p < 0.001). Correlation analyses showed that uveitic central foveal thickness before treatment was correlated with mfERG N1 response amplitude of area 1 (Spearman's r = ‐0.62, p < 0.001). VA (logMAR) after treatment had a negative correlation with the mfERG N1 response amplitude of area 1 (Spearman's r = ‐0.56, p = 0.001). Also, there was no correlation between the final VA and pre‐treatment OCT and mfERG measurements. Conclusion: This study deals with cystoid macular oedema associated with recurrent uveitis. In cystoid macular oedema, the value of mfERG before treatment is related to the central foveal thickness and VA. In contrast, after treatment the decrease of macular thickness is not always followed by an improvement of mfERG and VA. This supports the view that in uveitic macular oedema, the decrease in macular thickness after treatment may not be used as a predictor of improvement of macular function.     

First and second-order kernel multifocal electroretinography abnormalities in acute central serous chorioretinopathy

Purpose To evaluate the first and second-order kernel multifocal electroretinogram (mfERG) response abnormalities in patients with acute central serous chorioretinopathy (CSC). Methods This was a cross-sectional observational study in which 45 eyes of 45 patients with acute CSC underwent mfERG recordings. Peak amplitudes and implicit times of the first and second-order kernel responses were analyzed and compared with 20 age-matched normal controls. Correlation analyses were performed between the patients’ visual acuity and the first and second-order amplitudes and implicit times. Results The first-order N1 and P1 mfERG amplitudes in the central three concentric rings were reduced in eyes with acute CSC compared with controls (P < 0.05). The first-order P1 implicit times of the central four rings were also delayed (P < 0.05). For the second-order mfERG response, there were significant reductions in the second-order P1 and N1 amplitudes in rings 3–5 compared with controls (P < 0.05). No significant difference between the second-order P1 and N1 implicit times was found compared with controls (P > 0.05). Correlation analyses showed significant correlations between visual acuity and the first-order N1 response amplitudes of rings 1 and 2, and for the first-order N1 and P1 implicit times of rings 1–4 (P < 0.05). Conclusion Both first and second-order mfERG response abnormalities occur in eyes with acute CSC. These results suggest that in acute CSC, while outer retinal dysfunction is mostly localized to the central macula, there might be more widespread impairment in adaptive mechanisms of the inner retina or outer plexiform layer dysfunction in the more peripheral macula. Presented in part in the 44th annual symposium of the International Society of Clinical Electrophysiology of Vision (ISCEV), Fontevraud, France, June 2006.