黄斑病变患者多焦视网膜电图的变化

目的:观察黄斑病变多焦视网膜电图穴mERG雪特点,探讨mERG在黄斑功能测定中的有效性。方法:应用德国罗兰视觉诱发反应成像系统,对黄斑病变71 眼与正常人48眼进行mERG测定,记录103个视网膜部位的一阶反应(first orderkernel,FOK)比较分析视网膜后极部不同区域a波和b波的平均反应密度值和潜伏期,并观察其三维图的改变。结果:黄斑病变患者1～3环a、b波平均反应密度下降,与正常值比较有显著差异。5、6环平均反应密度下降,无显著差异。1～6环a、b波平均潜伏期较正常组明显延长,三维图形上主要特征为中心凹及黄斑振幅明显降低,严重者反应呈平坦。结论:mERG能客观地对黄斑病变局部视网膜功能进行定量定位测定,是评价黄斑病变的一种有效客观检测手段,为疾病诊断和治疗效果客观的测定提供了一种有效方法。     

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)     

糖尿病视网膜病变黄斑区的光学相干断层扫描及多焦视网膜电图图像特征

为了解糖尿病视网膜病变黄斑区的组织结构的改变及其相应的视网膜功能变化的关系。我们应用了光学相干断层扫描（ｏｐｔｉｃａｌ ｃｏｈｅｒｅｎｃｅ ｔｏｍｏｇｒａｐｈｙ,ＯＣＴ）及多焦视网膜电图（ｍｕｌｔｉｆｏｃａｌ ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｐｈｙ,ｍ－ＥＲＧ）检测了Ⅲ～Ⅳ期糖尿病视风膜病变患者３８例６０眼,结果显示ＯＣＴ图像特征大致可分五种形态,ｍ－ＥＲＧ反应密度图形可以反映出黄斑的视网膜功能并与黄斑区的组织形态的改变有较密切的关系。ＯＣＴ及ｍ－ＥＲＧ的应用为糖尿病视网膜病变患者黄斑病变的组织形态和视网膜功能的评价及随访提供可靠的检测手段。     

多焦视网膜电图在视网膜病变中的应用

目的探讨和评价多焦视网膜电图(ERG)对视网膜病变的应用价值。方法应用VERIS4.0视诱发反应图像系统检测了11例(11眼)特发性黄斑裂孔,24例(25眼)视网膜脱离和15例(30眼)视网膜色素变性的多焦ERG。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8min(分16段)记录103个视网膜部位的反应。结果与正常年龄组相比较,特发性黄斑裂孔,于1～2环N     

多焦视网膜电图的重复性探讨

多焦视网膜电图 (multifocal electroretinogram,m ERG)的刺激阵列由随离心度增加而面积相应增加的六边形组成 ,并由m-序列调制 ,可以同时分别刺激视网膜的各个不同部位 ,并将反应分离提取出来 ,可分析不同象限、不同环的反应密度及潜伏期 ,进而了解视网膜不同部位的功能状况。由于它较传统视觉电生理检查有其独到之处 ,因而越来越多地被运用到眼底病的相关研究领域[1 - 3 ] 。但是 ,目前对该系统重复性的研究国内外报道不多 ,我们通过对 16名正常人 16只眼的前后 2次 m ERG检测 ,对其重复性进行了探讨 ,现将结果报道如下。1　对象和方法…     

多焦视网膜电图与多焦视诱发电位检测的原理和临床应用

一、多焦视网膜电图 (ｍｕｌｔｉ ｆｏｃａｌＥＲＧ ,ｍＥＲＧ)的产生1877年Ｄｅｗａｒ首先记录了人眼对视刺激的电反应。1941年 ,Ｒｉｇｇｅｓ把接触镜电极引入到记录视网膜电图中(ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ ,ＥＲＧ) ;Ｋａｒｐ应用这种方法首次记录了视网膜色素变性中独特的ＥＲＧ反应。Ｓｕｔｔｅｒ和Ｔｒａｎ[1] 在 1992年发明了一种多焦ＥＲＧ系统 ,同时刺激视网膜的多个部位 ,独立采集每一处的反应情况[2 ] ,用地形图的方式直观显示视网膜各部位的反应情况。ｍＥＲＧ同时记录大量局部视网膜的反应 ,可以在短时间内发现细微…     

六种黄斑部病变的多焦视网膜电图比较

目的:比较6种黄斑病变的多焦视网膜电图(mERG)差异。 方法:记录了6种类型黄斑部病变患者的mERG,并与相应年龄组正常对照进行了比较。 结果:各种类型黄斑病变mERG均较正常对照组有显著差异,mERG各环N1、P1振幅反应降低,潜伏期延长(P<0.01);mERG振幅降低以中心1环处最为严重,随离心度增加mERG振幅与正常差异有逐渐减小趋势;在6种黄斑病变中mERG 1环振幅以渗出性老年性黄斑变性(ARMD)、中心性渗出性脉络膜视网膜病变、特发性黄斑裂孔和Stargardt病mERG降低较严重,而萎缩性ARMD、特发性黄斑部视网膜前膜及特发性中心性浆液性脉络膜视网膜病变mERG变化相对较轻。 结论:mERG是一种十分有效的黄斑功能测定方法;不同类型黄斑病变的黄斑功能在总体上存在有差异。眼科学报 2003;19:257-261。     

糖尿病视网膜病变患眼的多焦视网膜电图定量分析

糖尿病视网膜病变 (ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ ,ＤＲ)的全视野视网膜电图 (ｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ ,ＥＲＧ)改变已有不少研究 ,但由于传统的视网膜电图仅能记录视网膜的整体反应 ,而无法分辨各局部视网膜的电位反应 ,因此在ＤＲ的研究和临床应用中均存在着局限性。近来 ,Ｓｕｔｔｅｒ等[1] 发明了一种多焦视网膜电图 (ｍｕｌｔｉｆｏ ｃａｌｅｌｅｃｔｒｏｒｅｔｉｎｏｇｒａｍ ,ＭＥＲＧ)技术 ,在相对较短的时间测量整个测试野内许多细小部位的ＥＲＧ ,其一阶反应可反映视网膜内层的功能[2 ] 。我们对 30例增生…     

黄斑病变的多焦ERG特征

目的报告几种常见黄斑病变的多焦ERG特征.方法应用VERIS4.0视诱发反应图象系统检测黄斑裂孔、老年黄斑变性(干性型和湿性型)、中心性浆液性视网膜脉络膜病变、中心性渗出性视网膜脉络膜病变和Stargardt病于视网膜后极部26.6X22.1°内103个视网膜部位的反应曲线和立体功能图.结果;依据黄斑病变的病种和程度,反应曲线显示中心凹及黄斑区的反应降低或平坦,立体图显示峰值下降或凹陷.结论多焦ERG提供对黄斑病于黄斑区和后极部视网膜功能的定量和直观评价.     

糖尿病视网膜病变患者的多焦视网膜电图研究进展

糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病患者主要的眼部并发症,可以导致视力的严重损害.多焦视网膜电图是一项新的视觉电生理测量方法 ,能在相对较短的时间内测量整个测视野中许多细小部位的视网膜电图,可以反映局部视网膜的功能,对于DR的早期诊断具有极其重要的价值,并且能够定量地监测DR的进展情况,判断疗效和预后.     

Multifocal electroretinography in patients with Stargardt's macular dystrophy

AIMS—To describe the topography of multifocal electroretinograms (ERGs) and to explore its diagnostic value in patients with Stargardt's macular dystrophy (SMD).
METHODS—51 patients with SMD were examined by means of the m-sequence technique to characterise the topography of electroretinographic responses in the central visual field. The results were compared with data from 30 normal volunteers.
RESULTS—In 49 of 51 patients with SMD, macular electroretinographic activity was markedly diminished or non-detectable. Towards more peripheral areas, ERG responses of the SMD patients approached those of normals. Implicit times were not markedly delayed at any eccentricity.
CONCLUSION—In contrast with Ganzfeld electroretinography, multifocal electroretinography is useful to detect foveal dysfunction in SMD. Areas of dysfunction were found to be usually larger than expected from psychophysical measurements and morphological alteration. In early stages of the disease it was possible to detect foveal dysfunction, even in patients lacking morphological fundus changes and with good visual acuity.

Keywords: Stargardt's macular dystrophy; fundus flavimaculatus; electroretinography     

玻璃体腔注射康柏西普治疗湿性年龄相关性黄斑变性的早期mfERG变化

目的：利用多焦视网膜电图(mfERG)评价玻璃体腔注射康柏西普的湿性年龄相关性黄斑变性(age-related macular degeneration,ARMD)患者视网膜功能的早期变化。

方法：经眼底荧光血管造影确诊为湿性ARMD患者接受玻璃体腔注射康柏西普眼用注射液(0.05mL/0.5mg),记录注射前及注射后1mo的最佳矫正视力及mfERG各环N1、P1波潜伏期及P1波振幅密度。

结果：共20例20眼患者纳入研究,平均LogMAR视力从注射前0.80±0.48提高到注射后0.65±0.50(P<0.001),环1平均振幅密度从注射前39.59±16.60nV/deg²提高到注射后的53.81±20.41nV/deg²(P=0.006),振幅密度的改变与视力的改变呈正相关(r=-0.776,P<0.001)。

结论：对于湿性ARMD患者玻璃体腔注射康柏西普短期内能改善黄斑中心凹的功能。     

Multifocal electroretinography in central serous chorio-retinopathy and assessment of the reproducibility of the multifocal electroretinography

Purpose: To measure and compare the difference of multifocal electroretinography (mERG) in control subjects and patients with central serous chorio-retinopathy(CSCR) and assessing the reproducibility of the multifocal electroretinography. Methods: Sixteen cases of control subjects and 12 cases of central serous chorio-retinopathy were tested with the Visual Evoked Response Imaging System science4.2 made by EDI company of America. The results of the left eye of each control subject and patient were used for statistical evaluation by the Mann–Whitney U test. Repeat measurements were performed on 11 control subjects. Wilcoxon technique were used to quantify the reproducibility of the test. Results: The P₁ waveform average response density of 1–3 rings in central serous chorio-retinopathy were decreased statistically. There was no significant difference between repeat measurements on 11 individuals. Conclusion: Multifocal electroretinography can be used to quantify the visual function of the affected area in chorio-retinopathy and showed good agreement in the data distribution for the repeat measurements.     

Multifocal electroretinography in isolated arterially perfused bovine eye

AIM: To develop an isolated arterially perfused bovine eye as an in vitro model for studying retinal electrophysiology using multifocal electroretinography (mfERG). METHODS: Fresh bovine eyes were cannulated through the ophthalmic artery and perfused with oxygenated Krebs' solution at 37 degrees C within 15 min postmortem. Multifocal ERG was recorded using the veris 1.0 (Visual Evoked Response Imaging System). RESULTS: The mfERG waveform of in vitro bovine eyes had a typical trough (negative wave, N1) and peak (positive wave, P1) similar to those of human mfERG. The implicit times (peak latencies) for N1 and P1 were 20 and 42 ms respectively, and the average response amplitude (N1P1) was 55 nV. The implicit times of N1 and P1 were maintained for more than 4 h. The mfERG responses were affected proportionately by the stimulus intensity. Without a neutral density filter, the mean response amplitude was about 55 nV, which was diminished to 26, 18 and 10 nV under neutral density filters of 0.4, 1.0 and 1.4, respectively. Partial occlusion of the pupil completely abolished mfERG responses from the corresponding part of the retina. CONCLUSIONS: Isolated arterially perfused bovine eye may be used as an experimental model to study retinal electrophysiology using mfERG. The in vitro eye may offer a convenient and easily obtainable alternative to live animals, particularly for drug screening and invasive studies.     

Pattern electroretinography in senile macular degeneration

The value of pattern electroretinography (PERG) for the detection and differentiation of senile macular degeneration (SMD) was assessed. A group of patients with atrophic SMD and a group with exudative SMD were compared with an age-matched reference group. Differences were only found in visual acuity and in the amplitude of the negative peak N95. No statistical differences between the atrophic and exudative groups were found. Conclusions may be drawn from these results with regard to the use of PERG in senile macular degeneration.     

Multifocal electroretinography amplitudes increase after photocoagulation in areas with increased retinal thickness and hard exudates

Purpose: This study aimed to evaluate local response on multifocal electroretinography (mfERG) and to assess retinal thickness with optical coherence tomography (OCT) after focal laser treatment in areas with retinal oedema and exudates in patients with diabetic retinopathy. Methods: Twelve diabetes patients (aged 60 ± 14 years, diabetes duration 16 ± 8 years) treated with focal or grid photocoagulation in areas with retinal oedema and/or exudates underwent mfERG and OCT before and 3 months after treatment. The average thickness (in μm) in any of the nine sectors (defined according to the ETDRS) treated with photocoagulation was measured. Amplitudes and implicit times were analysed in corresponding areas on the mfERG. Results: Mean mfERG amplitudes increased after photocoagulation (21.5 ± 8.0 nV/deg² versus 16.8 ± 6.1 nV/deg²; p = 0.012), whereas no difference was seen in implicit times. Mean OCT values in the treated regions were lower at follow‐up (272 ± 23 μm versus 327 ± 79 μm; p = 0.013). No correlation was seen between changes in mfERG response and changes in OCT values. The decrease in retinal thickness was correlated with the number of laser spots applied (p = 0.002). Conclusions: Focal argon laser treatment is effective in reducing retinal thickness. In addition, treated areas tend to show improved retinal function as demonstrated by increased amplitudes on mfERG.     

Multifocal Electroretinography

Multifocal electroretinography (mfERG) provides functional and objective evidence of retinal dysfunction. We have found mfERG to be especially useful in the management of occult outer retinopathy and Stargardt’s disease.     

中心性浆液性脉络膜视网膜病变的多焦视网膜电图改变

目的 测试并比较中心性浆液性脉络膜视网膜病变(CSCR)患者和正常人的多焦视网膜电图，探讨CSCR患者的视网膜功能。方法 应用EDI公司生产的VERIS系统对8例CSCR12只眼和14例正常人的16只眼进行检测，检测结果进行Mann—Whitney检验。结果 CSCR患者1环、2环的P1波反应密度下降，与正常对照组相比差异有显著性意义。结论 多焦视网膜电图可对CSCR患者的视功能进行定量检测且具有较好的重复性。     

The changes of multifocal electroretinography in the early stage of photodynamic therapy for choroidal neovascularization

To investigate short-term changes in the multifocal electroretinography (ERG) recordings after photodynamic therapy (PDT) for choroidal neovascularization (CNV), 16 patients (17 eyes) with classic CNV confirmed by fluorescein angiography (FA) and indocyanine green angiography (ICGA), including 11 cases (12 eyes) of exudative age-related macular degeneration (AMD), two cases (two eyes) of pathological myopia and three cases (three eyes) of idiopathic causes, were treated using PDT with verteporfin. The multifocal ERGs of these patients were tested with VERIS Science^TM4.0 imaging system. The latencies and average response densities of all six ring retinal regions were measured and compared before PDT and 3 or 7 days after PDT. The latencies and amplitude densities of the N₁ and P₁ waves in all six rings remained unchanged at 3 or 7 days post-treatment (p>0.05). Therefore, there is no significant evidence to suggest an adverse effect from PDT for classic CNV on the outer retinal function in the early stage of treatment, with the aid of the multifocal ERG recordings.     

Comparison of ring 1 parameters in 37-segment multifocal electroretinography between onset and offset conditions of ring 2 to 4 in normal subjects

AIM: To investigate whether the response of a central hexagonal element corresponding to the macular area in conventional multifocal electroretinography (mfERG) tests was the same as that of experimental mfERG using single central hexagonal element stimulation. METHODS: Prospective, observational study. Thirty healthy subjects were included in this study. mfERG recordings were performed according to two protocols: stimulus with 37 hexagonal elements (protocol 1), and stimulus with a single central element created by deactivating the other 36 hexagonal elements (protocol 2). We compared differences between ring 1 parameters in each protocol. RESULTS: In protocol 1, the first positive component (P1) implicit time and P1 amplitude were 37.8±1.8ms and 6.3±2.7 μV. After single element stimulation (protocol 2), double positive waves appeared. The implicit time and amplitude of P1 were 40.7±2.4ms (P<0.001) and 9.1±3.3 μV (P=0.001), respectively. The implicit time and amplitude of the second positive component (P2) were 68.0±4.5ms (P<0.001, compared with P1 in protocol 1) and 12.3±4.7 μV (P<0.001, compared with P1 in protocol 1), respectively. The amplitude of P2 in protocol 2 was about two times higher than that of P1 in protocol 1. CONCLUSION: mfERG responses of a central hexagonal element in a single element stimulation protocol are different from those of multiple element stimulation. The positive wave is more enhanced compared to that of the conventional protocol and it elongated into two wavelets.