阈值和阈值前期早产儿视网膜病变儿童视网膜电图观察

目的用全视野闪光视网膜电图（F-ERG）评价既往患阈值或阈值前期早产儿视网膜病变（ROP）JL童的视网膜功能。方法用F-ERG检查34例（68眼）既往有早产儿童,患阈值或阈值前期ROP者24例（48眼）,出生年龄体重匹配的未患ROP者10例（20眼）。统计分析两组儿童暗视和明视各反应a波、b波潜伏期和振幅的差异。结果ROP组较对照组暗视视杆反应和最大混合反应a波、b波潜伏期延长,振幅降低,差异有统计学意义,P〈O．05。ROP组与对照组明视视锥反应a波、b波振幅和潜伏期无明显差别,P〉0．05。结论阈值或阈值前期ROP视网膜功能受到影响,以视杆细胞的功能降低为主。F-ERG是评价早产儿视网膜功能有效检测手段。     

应用视网膜电图评估早产儿视网膜病变退化后的视功能

目的通过闪光视网膜电图（flash electroretinogram,F-ERG）评估曾患早产儿视网膜病变（retinopathy ofprematurity,ROP）但自行消退的患儿的视功能情况,比较其与正常早产儿的异同。方法随机选择胎龄为26~36周,出生体重为990-2700g,曾患早产儿视网膜病变但自行消退的早产儿15例（30只眼）在半岁~2岁进行F-ERG检查,并选择胎龄、出生体重和检查年龄相似的正常早产儿作为对照组,对比F-ERG各波的振幅和潜伏期。结果 ROP组和正常对照组视杆反应b波潜伏期的差异有统计学意义（P〈0.05）,最大混合反应a波、b波,视锥反应a波、b波潜伏期的差异均无统计学意义;视杆反应b波,最大混合反应a波、b波,视锥反应a波、b波振幅及30Hz闪烁光及振荡电位峰值的差异均无统计学意义（P〉0.05）。结论早产儿视网膜病变退化后对患儿的视功能影响不大,因此,发现轻度的早产儿视网膜病变不必急于手术,可以密切观察其能否消退疾病进展再考虑是否手术,视杆细胞功能的损伤可考虑以后行视功能训练。     

阈值期和阈值前期早产儿视网膜病变的远期视网膜电图特征

目的 观察阈值期和阈值前期早产儿视网膜病变（ROP）的远期视网膜电图特征。方法 诊断为阈值期或阈值前期ROP的24例患儿48只眼（ROP组）纳入研究。选择出生年龄、体重与之匹配的未发生ROP的早产儿10例20只眼为对照组。经过湖南省儿童医院医学伦理委员会批准并取得所有受检者父母的知情同意后,所有受检儿行全视野闪光视网膜电图（F-ERG）检查,记录视杆反应、最大混合反应以及视锥反应。结果 与对照组比较,ROP组患儿的视杆反应b波潜伏期明显延长,差异有统计学意义（t=5.643,P＜0.05）;振幅明显降低,差异也有统计学意义（t=7.068,P＜0.05）。与对照组比较,ROP组患儿的最大混合反应a、b波潜伏期均延长,差异有统计学意义（t=3.099、2.886,P＜0.05）;振幅均降低,差异也有统计学意义（t=5.614、2.850,P＜0.05）。与对照组比较,ROP组患儿的视锥细胞反应a、b波潜伏期（t=0.819、0.948）及振幅（t=0.904、0.850）无明显变化,差异均无统计学意义（P＞0.05）。结论 阈值期和阈值前期ROP患儿远期视网膜视杆反应b波及最大混合反应a、b波潜伏期延长,振幅降低;视锥反应a、b波无明显变化。     

早产儿和足月产婴儿视网膜电图比较

目的了解早产儿视网膜功能发育程度。方法选取健康无眼病早产儿和足月产婴儿各25例进行闪光视网膜电图(ERG)检测，记录视杆细胞反应、视锥细胞反应及最大混合反应。对比分析两组婴儿的ERG各波反应的潜伏期、振幅以及最大反应b／a波振幅比值。结果与足月产婴儿比较，早产儿视杆细胞反应潜伏期延长（t=11.007，P=0.000），差异具有统计学意义，而振幅没有明显改变（t=1.836，P=0.069）；最大反应a、b波潜伏期延长(t=2.44，P=0.010;t=10.800，P=0.000)，而振幅降低(t=5.804，P=0.000; t=5.809，P=0.000)，差异具有统计学意义。两组婴儿视锥细胞反应除b波振幅无明显差异外（t=0.486，P=0.628），a波潜伏期（t=4.444，P=0.000）和振幅（t=3.819，P=0.000）及b波潜伏期（t=2.850，P=0.005）差异具有统计学意义。两组间最大混合反应的b／a波振幅比值没有明显差异（t=1.142，P=0.256）。结论早产儿视网膜发育程度较足月产婴儿稍低。(中华眼底病杂志,2005,21:285-287)     

视网膜电图在早产儿视网膜病变激光术后视网膜功能评价中的应用

目的 应用视网膜电图(electroretinogram,ERG)评价早产儿视网膜病变(retinopathyofpremature,ROP)激光术后视网膜功能的变化。方法 选取2011年1月至2012年12月在我院行激光光凝术的ROP患儿30例(60眼)为观察组,另选取同期视网膜发育正常的健康早产儿30例(60眼)为对照组,记录激光术后6个月的暗适应与明适应ERG,并对两组结果进行统计比较。结果 观察组视杆反应b波振幅为(131.47±36.20)μV,对照组为(149.33±40.14)μV,差异有统计学意义(P<0.05);观察组最大混合反应a波、b波振幅分别为(96.52±23.71)μV、(222.76±53.44)μV,对照组分别为(109.85±23.17)μV、(26044±52.28)μV,差异均有统计学意义(均为P<0.05);观察组振荡电位峰值为(37.71±22.23)μV,对照组为(49.70±32.24)μV,差异有统计学意义(P<0.05)。观察组视杆反应b波及最大混合反应a波、b波潜伏期与对照组差异均无统计学意义(均为P>0.05)。观察组视锥反应a波、b波振幅与对照组差异均无统计学意义(均为P>0.05),观察组视锥反应a波、b波潜伏期与对照组差异也均无统计学意义(均为P>0.05)。结论 经过激光光凝术治疗,ROP患儿视网膜视锥细胞功能发育与正常早产儿没有差别,而视杆细胞功能发育略差。     

正常早产儿与足月儿视网膜电图特征分析

目的了解正常早产儿与足月儿视网膜功能发育的特点。方法选取健康无眼病出生孕周小于37周的早产儿组63例(126只眼),其中孕周小于34周(含34周)早产儿1组28例(56只眼)和出生孕周大于34周早产儿2组35例(70只眼),足月组30例(60只眼)在出生后4～6周进行闪光视网膜电图(ERG)检测,记录视杆细胞反应、视锥细胞反应及最大混合反应。对比分析三组婴儿的ERG的a、b波反应的潜伏期、振幅。结果与足月组婴儿比较,早产组在视杆反应、最大混合反应、视锥反应中b波的潜伏期延长,幅值降低,差异有统计学意义(P=0.044,P=0.030,P=0.001,P=0.025,P=0.040,P=0.024),而a波除了在混合反应中的幅值差异有统计学意义外(P=0.012),其余潜伏期与幅值在视杆反应、最大混合反应、视锥反应中差异均无统计学意义(P=0.100,P=0.186,P=0.379,P=0.861,P=0.059)。而2组早产儿之间,早产1组视杆细胞反应、最大混合反应、视锥细胞反应a波、b波潜伏期较早产儿2组轻度延长,幅值轻度降低,但差异均无统计学意义(P=0.637,P=0.619,P=0.706,P=0.141,P=0.098,P=0.782;(P=0.635,P=0.059,P=0.125,P=0.606,P=0.348,P=0.634)。结论确定了正常足月儿和早产儿1个月龄时F-ERG的3个标准反应的正常值,并比较了各反应值与孕周的关系,发现早产儿视网膜发育程度较足月产婴儿稍低,且出生孕周越低,视网膜的发育程度越差。     

早产儿健康眼出生时视网膜电图特点

目的 了解早产儿出生时视网膜功能发育程度，比较早产儿和足月 产婴儿出生时视 网膜功能发育的异同。 方法 健康无眼病的早产儿10例10只眼和足月产 婴儿20例20只眼，随 机选取1只眼在出生后1周内进行闪光视网膜电图（FERG）检测，记录视杆细胞反应、视锥细 胞反应、最大混合反应，振荡电位（OPs）及30 Hz闪烁光反应。 结果 与足月产 婴儿比较，早产儿出生时视杆细胞反应潜伏期明显延长 (t=3.216，P=0.003)，振幅明显降低(t=6.050，P=0.000），差异有统计学意义；最大反应a、b波潜伏期差异无 统计学意义(t=0.465，P=0.650；t=1.068，P=0.295)，而振幅降低(t=6.584，P=0.000；t=6.649，P=0.000)差异有统计学意义。两组婴儿视锥细胞反应a、b波潜伏期 差异无统计学意义(t=0.077，P=0.939；t=0.935，P=0.358)，早产儿组振幅明显降 低(t=3.417，P=0.002；t=6.310，P=0.000)， 差异有统计学意义；两组间30 Hz闪烁光峰值潜伏期差异无统计学意义(t=0.968，P=0.341），早产儿组振幅明显降低（t=3.745，P=0.001），其差异有统计学意义。 两组间最大混合反应的b／a波振幅比值差异无统计学意义(t=0.215，P=0.831)。 结论 出生时早产儿视网膜的发育程度低于足月产婴儿。     

65—75岁老年人F—ERG观察

目的：观察65-75岁正常老年人暗适应闪光视网膜电图（F-ERG）,评价其视网膜功能。方法：对41例（69只眼）正常老年人行标准化视多膜电图（F-ERG）最大反应测定,将结果与对照组（30-40岁正常人）比较;并分别比较老年人中不同性别以及（老年性白内障）不同晶状体混浊度（按WHO白内障分级）对F-ERG影响。结果：65-75岁正常老年人F-ERG最大反应中a波振幅小于对照组（0.01＜P＜0.05),b波振幅明显小于对照组（P＜0.01);白内障眼F-ERG最大反应中a波振幅小于无白内障眼（0.01＜P＜0.05),b波振幅明显小于无白内障眼（P＜0.01);老年男性F-ERG最大反应中a波振幅组略上于女性,但差异无显著性（P＞0.1),而b波振幅明显小于女性（P＜0.01)。结论：随年龄增长,正常老年人暗适应闪光视网膜电图（F-ERG）反应减弱,视网膜功能将发生生理性减退;白内障所致晶状体混浊将进一步减弱ERG反应交影响视觉功能;F-ERG最大反应存在着性别差异。     

溶血卵磷脂酰基转移酶1自发突变小鼠视网膜组织和闪光视网膜电图改变

目的 观察溶血卵磷脂酰基转移酶1（LPCAT1）自发突变小鼠视网膜组织和闪光视网膜电图（F-ERG）改变情况。方法 Lpcat1基因自发突变纯合子的rd11新生小鼠60只（实验组）和与之同龄的野生型C57BL/6J小鼠60只（对照组）纳入实验。采用免疫荧光法检测两组小鼠视网膜组织中LPCAT1的表达情况。出生后3、6、9 d和2、4、6、8周,行视网膜石蜡切片观察视网膜显微结构;行全视野F-ERG检测,记录暗视杆体反应和明视锥体反应。结果 实验组小鼠视网膜组织中LPCAT1呈阴性表达;对照组小鼠视网膜组织中LPCAT1呈阳性表达,主要分布于视网膜光感受器内节,神经节细胞层可见少量表达。光学显微镜观察发现,实验组小鼠于出生后9 d左右视网膜外核层已基本形成,其光感受器细胞核层数随年龄增长而逐渐减少。对照组小鼠视网膜显微结构正常。F-ERG检测结果 显示,实验组小鼠出生后2、4周暗视杆体系统反应存在,呈降低趋势,出生后6~8周暗视杆体系统反应消失;对照组小鼠各时间点暗视杆体系统反应正常。出生后2周,实验组和对照组小鼠b波振幅分别为（72.8±15.6）、（105.2±21.1） μV,实验组较对照组降低,但差异无统计学意义（t=-2.760,P=0.025）。出生后4周,实验组和对照组小鼠b波振幅分别为（20.6±6.4）、（231.8±32.0） μV,实验组较对照组明显降低,差异有统计学意义（t=-14.471,P=0.000）。实验组小鼠出生后2、4、6周明视锥体系统反应存在,呈降低趋势,出生后8周明视锥体系统反应消失;对照组小鼠各时间点明视锥体系统反应正常。出生后2、4周,实验组小鼠b波振幅分别为（46.8±7.2）、（78.0±8.2） μV;对照组小鼠b波振幅分别为（42.8±6.4）、（91.4±9.4） μV。两组比较,差异均无统计学意义（t=0.930、-2.401,P=0.379、0.043）。出生后6周,实验组和对照组小鼠b波振幅分别为（17.2±2.0）、（116.2±12.9） μV,实验组较对照组明显降低,差异有统计学意义（t=-17.008,P=0.000）。结论 LPCAT1自发突变小鼠视网膜外层光感受器细胞核层数随年龄增长而逐渐减少,F-ERG暗视杆体和明视锥体反应异常。     

早产儿视网膜病变激光光凝治疗后视网膜功能发育状况观察

目的 观察早产儿视网膜病变(ROP)患儿视网膜激光光凝治疗后的视网膜功能发育状况.方法 对30例患阈值期ROP并成功接受视网膜激光光凝治疗的早产儿(病例组)和30例无ROP早产儿(对照组)进行闪光视网膜电图(F-ERG)检查,记录视杆细胞反应、视锥细胞反应、最大混合反应及振荡电位.结果 与对照组比较,病例组视杆细胞反应...     

The cone electroretinogram in retinopathy of prematurity

PURPOSE: To test the hypothesis that retinopathy of prematurity (ROP) affects the cone photoreceptors less than the rod photoreceptors. METHODS: Electroretinogram (ERG) responses to a 1.8-log-unit range of red flashes on a white, rod-saturating background were recorded in 42 subjects with a history of preterm birth and ROP (28 untreated; 6 treated) or no ROP (n = 8). The sensitivity (S(CONE)) and saturated amplitude (R(CONE)) of the cone photoresponse were calculated by fit of a model of the activation of cone phototransduction to the a-waves. The cone-driven b-wave amplitude was evaluated as a function of stimulus intensity. S(CONE) and R(CONE) were compared to the rod response parameters (S(ROD), R(ROD)) recorded from the same preterm subjects. Responses in the former preterm subjects were compared to those in control subjects. RESULTS: The values of S(CONE) and R(CONE) in the preterm subjects overlapped broadly with those in the control subjects. The shapes of the b-wave stimulus-response functions did not differ between preterm and control subjects. The relative value of S(CONE) was significantly greater than that of S(ROD). CONCLUSIONS: ROP has less effect on the cone than on the rod photoresponses, suggesting that cones are more resistant to the ROP disease process. The similar shape of the b-wave stimulus-response function in preterms and control subjects is evidence that ROP does not alter the balance of ON and OFF signals in the cone pathway.     

显微白内障手术光性视网膜损伤的F—ERG观察

目的　观察现代囊外白内障术中显微镜光照对视网膜功能的影响。方法　应用国际标准化视网膜电流图(F-ERG)记录45例45眼白内障术前及(白内障囊外摘出)术后1moF-ERG最大反应(MCR)(a、b波振幅)。按(WHO)晶状体混浊度分级采用不同术式,A组PHACO术、B组ECCE术。A组术中实际曝光于显微镜下25～40min(31.4min±4.1min),中度光强;B组50～75min(59.8min±8.7min),中高度光强。比较2组中使用不同显微镜光照(时间和光强)对ERG反应的影响,评价其对视网膜功能的损害。结果　白内障术后1moF-ERGa、b波振幅较术前均有不同程度的增大(0.01＜P＜0.05);A组术后F-ERG振幅较术前明显增大(P＜0.01);B组较术前增大,但无显著性差异(0.01＜P＜0.05)。结论　白内障术后ERG反应有不同程度的增强,提示晶状体混浊可减弱ERG反应;显微镜光照下手术时间越长、光照越强,术后1moF-ERG反应增幅越小,提示持续显微镜下手术可致视网膜光毒性损伤。     

Rod and cone photoreceptor function in patients with cone dystrophy

PURPOSE: To determine the extent of rod and cone photoreceptor dysfunction in patients with cone dystrophy using psychophysical and electrophysiological tests. METHODS: Ten patients with cone dystrophy participated. Rod and cone system psychophysical thresholds were measured as a function of retinal eccentricity. Bright-flash full-field electroretinograms were obtained under dark-adapted (rod-mediated) and light-adapted (cone-mediated) conditions. The a-wave data were fitted with a model based on photopigment transduction to obtain values for log Rmax (maximum response) and log S (sensitivity). b-Wave parameters were also examined by fitting a nonlinear, saturating function (the Naka-Rushton equation) to the rod-mediated responses. Oscillatory potentials were measured to the cone-mediated high-intensity flashes. RESULTS: On average, the rod-mediated psychophysical thresholds were elevated by 0.5 log unit. These threshold elevations did not differ significantly with retinal eccentricity. In contrast, cone-mediated psychophysical thresholds were elevated up to 3.0 log units. Threshold elevation was greatest in the central retinal locations. For rod-mediated conditions, the a-wave Rmax parameter was significantly reduced in three patients; the a-wave log S parameter was within normal limits. The rod-mediated b-wave Rmax parameter was reduced in six patients; log k was abnormal in one patient. For cone-mediated conditions, the a-wave Rmax parameter was reduced in six patients and the a-wave log S parameter was reduced in two patients. The cone system oscillatory potentials were abnormal in nine patients. CONCLUSIONS: Patients with cone dystrophy show different patterns of psychophysical rod versus cone system sensitivity losses with retinal eccentricity. The full-field electrophysiological data indicate that most of the patients had abnormal cone photoreceptor function. Some patients also showed rod photoreceptor abnormalities. The rod system changes were smaller than the cone system changes.     

早产儿视网膜功能的全视野闪光视网膜电图检查

目的 观察早产儿视网膜功能变化特征。方法 对78例4～5个月婴儿在口服镇静 剂熟睡后进行全视野闪光视网膜电图（ERG)检查，测量各项反应的a波和b波的振幅和隐含期 ，以评价未成熟儿的视网膜功能。78例156只眼中，健康足月产儿33例66只眼，健康早产儿2 5例50只眼，早产儿视网膜病变（ROP）患儿20例40只眼。结果 所有足 月产儿和健康早产儿 都可以记录到明显的ERG波形。足月产儿的标准混合反应b波振幅为388.7 μV，健康早产儿 的标准混合反应b波振幅为336.7 μV，分别为正常成人混合反应b波振幅的64.4％和55.6 ％。ROP患儿中，20只眼记录不到波形，其余20只眼的标准混合反应b波振幅为183.8 μV，和足月产儿相比，隐含期也显著延迟。健康早产儿的ERG振幅较足月产儿 轻度降低， 差异有统计学意义。结论 出生后视网膜还处于不断成熟发育过程中， 健康足月产儿的ER G尚未达到正常成人的水平；早产儿视网膜发育程度较足月儿慢，不论是健康早产儿还是ROP 患儿，其ERG均不及健康足月产儿。因此ERG检查是评价早产儿视网膜功能的有效方法。     

Mutations of the XLRS1 gene cause abnormalities of photoreceptor as well as inner retinal responses of the ERG

Intensity-series rod and cone ERGs were recorded in 19 patients with XLRS and 26 control eyes. All patients were examined by one ophthalmologist and diagnosed on the basis of fundus appearance and evidence of the disease in other males in the same family. Mutations in the XLRS1 gene have been identified in 15 of the patients. Dark-adapted ERGs were significantly different from controls for all test conditions and for both a-wave and b-wave responses. Abnormalities were detectable in all patients but there was considerable variation in the severity of abnormality. One third of the patients had the dark-adapted `negative-wave' response typically associated with inner retinal disorder, but about one third showed only mild depression of the b-wave while the remainder had abnormally low a-waves in addition to depressed b-waves. Light-adapted responses were also affected and both a-wave and b-wave responses differed significantly from controls, but the `negative-wave' response was not seen in any patient. The severity of the ERG abnormality did not correlate with the classification of fundus appearance or patient age suggesting that retinal function is relatively stable throughout life. The severity of ERG abnormalities did not correlate with the type of mutation and responses could differ between affected males within the same family. These results indicate considerable heterogeneity of ERG response without clinical, age or genetic correlate. The abnormal a-wave responses indicate that photoreceptor as well as inner retinal layer function may be affected in XLRS, at least in some patients. This revised version was published online in July 2006 with corrections to the Cover Date.     

Comparison of electroretinographic responses between two different age groups of adult Dark Agouti rats

AIM: To describe and compare the differences in electroretinographic responses between two different age groups of adult Dark Agouti (DA) rats and to better understand the effect of age on retinal histology and function.METHODS: The electroretinographic responses of two different age groups of adult DA rats were compared. Animals were divided into younger adult DA rats 10-12wk (n=8) and older adult DA rats 17-19wk (n=8). Full field electroretinography (ERG) was recorded simultaneously from both eyes after dark adaption and light adaption and parameters including the positive scotopic threshold response (pSTR), negative scotopic threshold response (nSTR), scotopic a-wave, b-wave, photopic a-wave, b-wave and photopic negative response (PhNR) were compared between groups.RESULTS: The older adult rats displayed lower stimulation thresholds of the STRs (pSTR and nSTR) and higher amplitudes of pSTR, scotopic a-wave and b-wave, photopic b-wave and PhNR amplitudes, with shorter implicit times. Photopic a-wave amplitudes were however higher in the younger adult rats.CONCLUSION:In summary, for the rod system, photoreceptor, bipolar cell and RGC activity was enhanced in the older adult rats. For the cone system, RGC and bipolar cell activity was enhanced, while photoreceptor activity was depressed in the older adult rats. Such age-related selective modification of retinal cell function needs to be considered when conducting ophthalmic research in adult rats.