挫伤眼球视功能的电生理评价

目的：研究挫伤眼球的多焦视网膜电图（MERG）改变，探讨多焦电生理检查在眼球挫伤中的应用价值。方法：视网膜挫伤患者44例47眼，应用国产多焦电生理系统国特GT2000NV进行MERG检查，对伤眼与正常眼的总体参数及各环的振幅和潜伏期进行比较。结果：受伤眼的矫正视力与中心凹区一环的b波振幅密度之间具有线性正相关关系：伤眼与正常眼之间多焦视网膜电图的a波及b波的潜伏期及一环b波振幅密度值的差异具有显著性。结论：国产多焦电生理系统能够客观反映挫伤眼球的视功能损害程度，是评价眼球挫伤患者视功能的客观有效工具。     

高眼压和青光眼的多焦视网膜电图表现

目的 评价多焦视网膜电图（MERG）在青光眼早期诊断中的价值。方法 测定28例35眼正常对照者、7例7眼高眼压者和11例14眼开角型青光眼者的全视野ERG最大反应及MERG。结果 青光眼和高眼压组的MERG一阶kernel反应P1波反应密度低于正常组,P1波峰时无明显延长,全视野ERG最大反应各组无显著差异。结论 MERG的一阶kernel反应在高眼压和青光眼均有改变。     

不同程度糖尿病视网膜病变的多焦视网膜电图特征及差异

糖尿病视网膜病变 (diabetic retinopathy,DR)的全视野视网膜电图及振荡电位改变已有不少研究。近来 ,Sutter等 [1 ]发明的多焦视网膜电图 (multifocal electroretinograms,MERG)技术 ,可同时分别刺激视网膜多个不同部位 ,能在较短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 ]。本研究观察了 6 4例 DR患者 6 4只眼的 MERG改变 ,现报告如下。1　对象和方法对象 :经散瞳直、间接检眼镜检查、眼底彩色照相和荧光素眼底血管造影确诊为 DR ～ 期的患者 30例 30只眼 ,其中男 16例 ,女 14例 ,年龄 49～…     

黄斑病变手术前后黄斑区视网膜的解剖和视功能评估

光学相干断层扫描（optical coherence tomography,OCT)是一种新的光学诊断技术,多焦视网膜电图（multifocal electroretinography,MERG)是一种新型的视觉电生理学技术。两者对于黄斑部疾病的诊断、病情观察、疗效评价等均具有特别重要的价值。现就OCT、MERG在黄斑疾病手术前后黄斑区视网膜的解剖形态和视功能评估方面的应用作一综述。     

三个时期糖尿病视网膜病变多焦视网膜电图的差异

目的研究三个时期糖尿病视网膜病变的多焦视网膜电图特征及其临床意义。方法采用VERISⅣ视觉诱发反应图像系统测量和分析了34例非增殖期、15例增殖前期和15例增殖期糖尿病视网膜病变的多焦视网膜电图的差异。结果与正常对照眼比较,增殖期糖尿病视网膜病变,多焦视网膜电图的N     

大鼠四氧化二氮中毒后多焦视网膜电图改变

目的:研究大鼠在航天推进剂四氧化二氮染毒后多焦视网膜电图改变.方法:正常雄性winstar大鼠,用15mg四氧化二氮溶液ip染毒,1h及7d检查的大鼠为6～10只,在晚上固定时间进行苯巴比妥钠溶液ip麻醉及多焦视网膜电图检查.用Microsof Excel自带的统计软件对数据进行分析.结果:四氧化二氮15mg染毒后1h组的大鼠与正常大鼠的MERG的总和波及各环b波的潜伏期的差异具有显著意义(P值0.005～0.034,P＜0.05);染毒后7d的大鼠与正常大鼠MERG的总和波及各环b波的潜伏期的差异没有显著意义;两组染毒大鼠与正常大鼠MERG的总和波及各环b波的波幅值的差异均无显著意义.染毒后1h组与染毒后7d组之间的MERG的总和波及各环b波的潜伏期的差异其部分指标具有显著意义(P值0.006～0.017,P＜0.05),其余部分指标的差异无显著意义;而两组之间波幅值的差异无显著意义.结论:1h及7d四氧化二氮染毒大鼠的MERG潜伏期的差异其部分指标具有显著意义,MERG总和波及各环b波潜伏期有不同程度的差异,其影响随着时间延长而减弱.     

光凝所致糖尿病视网膜病变视网膜功能 改变的定量研究

目的探讨视网膜光凝术对糖尿病视网膜病变视网膜功能的早期影响。方法应用多焦视觉诱发反应图象系统(visual evoked response image system, VERIS )对21例30只眼Ⅲ～Ⅳ期糖尿病视网膜病变视网膜光凝术前、术后第3 d和术后第7 d的多焦视网膜电图(multifocal electroretinograms, MERG)进行了定量研究。结果与术前比较,光凝术后第3　d黄斑中央5°区域和鼻上象限N1波潜伏期显著延长,MERG各波反应密度均较术前显著降低。与接受光凝部位相应的视野鼻下象限N1波和P1波反应密度变化值大于其余三个象限,但仅在鼻下象限与颞上象限之间差异有显著性的意义。黄斑中央5°区域M ERG各波反应密度下降幅度最大,黄斑中央10°区域次之,均大于各象限。术后第3　d术眼视力的变化值与黄斑区各波反应密度的变化值呈显著的正相关。术后第7 d,MERG各波反应密度有所恢复,但N1波和P1波反应密度仍较术前降低。结论糖尿病视网膜病变视网膜光凝术后早期视网膜功能显著下降,光凝间接引起的黄斑区视网膜功能损害是术后早期部分患者中心视力下降的重要因素。(中华眼底病杂志,2001,17:181-183)     

多焦视网膜电图在青光眼早期诊断中的应用

多焦视网膜电图（multifocalelectroretinogram，mfERG）在眼科领域的应用是视觉电生理学的一项重要新进展，用它评价视网膜外层和中层功能障碍（如视网膜营养不良）的价值已得到肯定。但用多焦视网膜电图检测主要以内层视网膜损害为主的青光眼，尤其是用于早期诊断，仍存在许多问题有待解决。本文介绍了多焦视网膜电图的基本原理、正常人多焦视网膜电图特征、青光眼及高眼压症多焦视网膜电图的改变以及多焦视网膜电图与青光眼视野缺损的关系。     

多焦视网膜电图对近视眼的临床研究

目的:测试近视眼患者的多焦视网膜电图的改变。方法:应用美国EDI公司生产的VERISScience4.2多焦视网膜电图检查仪对24例48眼近视患者,22例44眼正常者进行检测,分析其总体和6个环形视网膜区域的反应。结果:近视患者总体和6个环形视网膜区域的反应密度均低于正常者,潜伏期无明显改变。结论:近视患者多焦视网膜电图的反应密度下降,这种改变主要是由于视网膜感受器功能受损所致。     

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)     

Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional Form of Bietti‘s Crystalline Retinopathy

Purpose:To observe different features of indocyanine green angiography(ICGA) and multifocal electroretinography(ERG)in the diffuse and regional type of Bieti‘s crystalline retinopathy(BCR).MEthods:ICGA and the multifocal ERG were performed in two cases of the diffuse and regional type of BCR respectively.These data were compared with fluorescein angiography(FA),Standard Ganzfeld ERG,and visual field testing.Results:In the regional case,ICGA revealed reduced perfusion of the choroidal circulation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase,due to choriocapillaris filling defect;the extent of choroiocapillaris loss was shown in early phase of ICGA and there were multifocal hyperfluorescent dots surrounding hypofluorescent spots in late phase in the diffuse case.The multifocal ERG showed that the central responses were markedly depressed,corresponding to the visual field defects,while the findings of Ganzfeld ERG were normal in the regional BCR;However,both the multifocal ERG and Ganzfeld ERG were severely subnormal in the diffuse case.Conclusions:The features of ICGA and multifocal ERG are different between the diffuse and regional BCR.In the meantime,the two tools are also useful to differentiate the type and assess the extent of evolution in BCR.     

Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional Form of Bietti′s Crystalline Retinopathy

Prpose: To observe different features of indocyanine green angiography(ICGA) andtifocal electroretinography (ERG) in the diffuse and regional type of Bieti′sc stalline retinopathy (BCR). Thods: ICGA and the multifocal ERG were performed in two cases of the diffuse andregional type of BCR respectively. These data were compared with fluoresceinangiography (FA), standard Ganzfeld ERG, and visual field testing. Results: In the regional case, ICGA revealed reduced perfusion of the choroidalcirculation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase, due to choriocapillaris filling defect; the extent of choroiocapillaris losswas shown in early phase of ICGA and there were multifocal hyperfluorescent dotssurrounding hypofluorescent spots in late phase in the diffuse case. The multifocal ERGshowed that the central responses were markedly depressed, corresponding to the visualfield defects, while the findings of Ganzfeld ERG were normal in the regional BCR;however, both the multifocal ERG and Ganzfeld ERG were severely subnormal in thediffuse case.Conclusions: The features of ICGA and multifocal ERG are different between the diffuseand regional BCR. In the meantime, the two tools are also useful to differentiate the typeand assess the extentof evolution in BCR.     

Multifocal steady-state pattern-reversal electroretinography in glaucoma patients

AIM: This study was designed to answer the question of whether multifocal steady-state pattern-reversal electroretinography (ERG) is capable of detecting glaucomatous visual field defects. METHOD: Sixteen patients (28 eyes) and ten normal subjects (20 eyes) were examined. Multifocal pattern ERGs were recorded with the RETIscan system and DTL electrodes. We stimulated with a steady-state checkerboard pattern reversal (three reversals during 171 ms sweep length, congruent with 17.5 reversals/s). The multifocal pattern ERG amplitudes were evaluated using discrete Fourier transformation (DFT) across three reversals. In cases of advanced glaucoma, the DFT-calculated amplitudes were combined in hemispheres and checked for correlations with corresponding visual field defects. In all binocularly examined persons, side comparisons ("worse" eye vs "better" eye), and interindividual comparisons (glaucoma vs normal) were carried out. RESULTS: In interindividual comparisons and interocular side comparisons, significant amplitude reductions of the "worse" eyes were seen in the foveal records. No topographical correlation between multifocal pattern ERG amplitudes and visual field defects could be found. CONCLUSIONS: In glaucomatous visual field defects, multifocal steady-state pattern-reversal ERG using the present stimulation was significantly reduced in its foveal records but seems to be incapable of detecting them topographically.     

Dark-adapted red flash ERGs in healthy adults

Clinical electrophysiological testing of the visual system incorporates a range of noninvasive tests and provides an objective indication of function relating to different locations and cell types within the visual system. This document developed by the International Society for Clinical Electrophysiology of Vision provides an introduction to standard visual electrodiagnostic procedures in widespread use including the full-field electroretinogram (ERG), the pattern electroretinogram (pattern ERG or PERG), the multifocal electroretinogram (multifocal ERG or mfERG), the electrooculogram (EOG) and the cortical-derived visual evoked potential (VEP). The guideline outlines the basic principles of testing. Common clinical presentations and symptoms are described with illustrative examples and suggested investigation strategies.     

Annular fundus autofluorescence abnormality in a case of macular dystrophy

Purpose: To present a case of macular dystrophy with early changes in fundus autofluorescence. Methods: A 20-year-old woman with a recent loss of visual acuity and onset of photophobia was examined. Color vision and visual field testing, fluorescein angiography, full-field and multifocal electroretinograms as well as fundus autofluorescence were performed. Results: Best-corrected visual acuity was 20/100 (right eye) and 20/60 (left eye). There was a red-green color vision defect and a relative central scotoma in both eyes. Ophthalmoscopy and fluorescein angiography were essentially normal, the presence of a dark choroid was debatable. Full-field ERG responses were normal, but the multifocal ERG showed severely reduced responses in the macular region. Both eyes showed a slight circular parafoveolar increase of fundus autofluorescence. Conclusion: Besides multifocal ERG, fundus autofluorescence aids to objectively assess the manifestation of macular dystrophies but does not discern between different types in early stages.     

Normal fundus and abnormal electroretinogram: differential diagnosis

PURPOSE: To assess retinal dysfunction when ophthalmoscopy reveals normal features. METHODS: Ganzfeld electroretinography of the rod and of the cone systems was used to detect congenital or acquired retinal dysfunction. In infants under 5 years of age ERG was performed using inhalational anaesthesia. In addition, multifocal ERG techniques detect discrete local retinal dysfunctions. The ERG results are evaluated in comparison to normative data and to ophthalmoscopic as well as perimetric results. Patient data were selected to demonstrate typical ERG changes and the corresponding differential diagnosis. RESULTS: Abnormalities in ERG results and normal ophthalmoscopic features are shown in 8 typical examples. They were observed in the following conditions: (1) stationary congenital dysfunctions, (2) early stages of the hereditary tapetoretinal degenerations, and (3) toxic or cancer-associated retinopathies. In these disorders the ERG complemented visual field testing by detecting isolated dysfunction of the rod- and cone-systems. CONCLUSION: In the context of making crucial diagnostic decisions ERG complements ophthalmoscopy and psychophysical testing of the retinal function. This diagnostic test facilitates differential diagnosis, helps to establish prognosis, and provides a basis for genetic counselling.     

Multifocal electroretinography, color discrimination and ocular toxicity in tamoxifen use

PURPOSE: To study prospectively retinal function, color discrimination, and ocular toxicity in women treated with standard-dosage tamoxifen for breast cancer. METHODS: Thirty visually asymptomatic patients with at least 2 years of continuous tamoxifen therapy underwent multifocal electroretinography (ERG), color discrimination testing, and ophthalmic examination. The results were compared with 17 patients who were not taking tamoxifen after breast cancer surgery and to an additional age-matched group of 21 healthy women. RESULTS: Multifocal electroretinogram amplitudes and latencies were comparable among the three studied groups, and individual recordings were within age norms from our own lab. In the treated group, mild diffuse color vision loss was found in two patients with normal fundi. Three other patients had ocular toxic effects, with two cases of refractile retinal crystals and one case of keratopathy. CONCLUSIONS: The aspects of central retinal function that are assessed by multifocal ERG were not affected even after at least 2 years of tamoxifen use, suggesting that the multifocal ERG is not sufficiently sensitive to detect tamoxifen-associated change that might occur. Some degree of color vision loss and ocular toxic effects were found in a few cases of this cohort suggesting that women using tamoxifen should receive an eye exam at least as often as recommended for middle-aged people.     

Late onset cone dystrophy

Cone dystrophies are a hereditary, progressive and heterogeneous group of retinal diseases with cone system degeneration. They lead to reduced visual acuity, colour vision impairment and photophobia. Full-field electroretinogram (ERG) reveals severe cone function impairment, with normal rod responses or slightly depressed in advanced stages in some cases. The purpose of the study was to present a case of late onset cone dystrophy in 47-year-old male and the proper diagnostic procedure. A 47-year-old patient presented with progressive visual loss for several years and mild photophobia, which he observed recently. The patient underwent fundus photography, fluorescein angiography, colour vision testing, Goldmann visual field testing, full-field electroretinogram (ERG) and multifocal electroretinogram (mfERG). Symptoms and signs of late onset cone dystrophy may be unclear and establishing the proper diagnosis may be difficult in these cases. Patients may be misdiagnosed as having other diseases, especially in case of absence or subtle changes in the macula. The electrophysiological testing is essential in these cases, and ERG is the most useful clinical test in early and differential diagnosis of retinal dystrophies.     

Identifying inner retinal contributions to the human multifocal ERG.

Contributions to the multifocal electroretinogram (ERG) from the inner retina (i.e. ganglion and amacrine cells) were identified by recording from monkeys before and after intravitreal injections of n-methyl DL aspartate (NMDLA) and/or tetrodotoxin (TTX). Components similar in waveform to those removed by the drugs were identified in the human multifocal ERG if the stimulus contrast was set at 50% rather than the typically employed 100% contrast. These components were found to be missing or diminished in the records from some patients with glaucoma and diabetes, diseases which affect the inner retina.     

Testing central retinal function with multifocal electroretinography before and after photodynamic therapy

BACKGROUND: Photodynamic therapy (PDT) is applied for certain forms of choroidal neovascular membrane (CNV). The aim of this study was to investigate the effect of PDT on central retinal function as assessed by multifocal electroretinography (ERG). METHODS: 24 patients (25 eyes) with CNV (>50% classic 12 eyes) or occult (9 eyes) in age related macular degeneration (AMD) and CNV with pathological myopia (4 eyes) were treated by PDT using Verteporfin((R)). Before and a median of 6 weeks after therapy, central retinal function was examined using multifocal ERG (RetiScan, 61 hexagons, first-order response). RESULTS: In the area of treatment,we found a tendency of the amplitude of the first positive deflection (P1) to decrease and of the implicit time to increase, but both effects were not statistically significant. These alterations were more pronounced in eyes with occult CNV and in myopia-related CNV. Amplitude reduction and implicit time prolongation could also be found in the areas represented by the multifocal ERG but not treated. There was no significant correlation between change in visual acuity after PDT and amplitude of the multifocal ERG. CONCLUSION: The effects of PDT on retinal function seem to be moderate as assessed by multifocal ERG. An inherent problem of this investigation was the recruitment of nontreated patients as controls. Future goals are investigations of patients with repeated PDT and of long-term alterations in multifocal ERG after PDT.