眼部缺血综合征患者视网膜电图明视负向反应和震荡电位的变化特点

目的观察眼部缺血综合征(ocular ischemic syndrome,OIS)患者视网膜电图(electroretinogram,ERG)明视负向反应(PhNR)和震荡电位(oscillatory potentials,OPs)的变化特点。方法选取2009年6月至2010年2月在我院就诊的OIS患者12例15眼行常规闪光ERG检查,同时选取正常对照眼15人15眼,视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)患者15例15眼行闪光ERG检查。比较OIS患眼与正常对照眼、CRVO患眼的PhNR和OPs,及其余各项ERG指标的振幅变化差异。采用Stata11统计学软件分析受试者工作曲线下面积(AUC),并进行数据分析,比较OPs及PhNR区分正常眼及OIS眼的敏感度及特异性。结果 PhNR振幅在OIS组为(49.36±12.20)μV、CRVO组为(25.62±6.72)μV、正常组为(59.79±11.83)μV。三组之间两两比较,差异有显著统计学意义(F=41.287,P<0.01)。OPs振幅在OIS组为(128.44±23.86)μV、CRVO组为(102.69±10.55)μV、正常组为(154.01±15.08)μV。三组之间两两比较,差异也有显著统计学意义(F=78.098,P<0.01)。PhNR指标的AUC为0.7240±0.0945,95%的可信区间为(0.53871,0.90925),其敏感度为73.3%,特异性为86.7%。OPs指标的AUC为0.8170±0.0810,95%的可信区间为(0.65814,0.97579),其敏感度为86.7%,特异性为80.0%。结论 OIS患者PhNR、OPs振幅较正常对照组明显降低,但较CRVO患者降低程度轻,表明OIS患者视网膜组织存在缺血的现象,但其缺血程度较CRVO患者轻。OPs在评估OIS患者内层视网膜的血液循环功能方面比PhNR更好。

Changes of photopic negative response and oscillation potentials of electroretinogram in ocular ischemic syndrome

Objective To observe the changes of photopic negative response(PhNR) and oscillation potentials(OPs) of electroretinogram(ERG) in ocular ischemic syndrome(OIS).Methods Twelve patients(15 eyes) with OIS diagnosed in our hospital from June 2009 to February 2010 were retrospectively analyzed and underwent routine electroretinogram examination,meanwhile,15 cases(15 eyes) in control normal group and 15 cases(15 eyes) in central retinal vein occlusion(CRVO) group also underwent routine electroretinogram examination.The changes of PhNR and OPs were compared among three groups,and the differences of amplitude in other indexes of ERG were also compared.The specificity and sensitivity of PhNR and OPs in diagnosis of OIS were evaluated using the area under receiver operating characteristics curve(AUC).Results The average values of the wave amplitude of PhNR in OIS group was (49.35±12.20)μV,CRVO group was(25.62±6.72)μV and control normal group was(59.79±11.83)μV,there was significant difference(F=41.287,P<0.01).The average values of the wave amplitude of OPs in OIS group was (128.44±23.86)μV,in CRVO group was(102.69±10.55)μV and in control normal group was(154.01±15.08)μV,there was significant difference(F=78.098,P<0.01).AUC of PhNR and OPs were 0.724 0±0.094 5(95% CI:0.538 71-0.909 25) and 0.817 0±0.081 0(95% CI:0.658 14-0.975 79),respectively.The sensitivity and specificity of PhNR were 73.3% and 86.7%,OPs were 86.7% and 80.0%.Conclusion The wave amplitudes of PhNR and OPs in OIS group evidently reduce compared with control normal group,decrease slightly compared with CRVO group.It showed that there is retinal ischemic phenomenon of OIS patients,but the ischemic degree is much slight compared with CRVO patients.In evaluating the blood circulation in retinal inner layer of OIS patients,OPs is better than PhNR.