多焦视网膜电图及彩色多普勒在视网膜脱离术患者中的应用

目的：通过对视网膜脱离患者术前、术后的血流动力学研究及视网膜功能的了解，判断视网膜脱离患者的术后恢复情况，并探讨两种检测方法的临床价值。方法：对我院62例孔源性视网膜脱离患者，通过彩色多普勒（CDI）检测视网膜中央动脉（CRA）的收缩期峰值流速（Vmax）、舒张末期流速（Vmin）、阻力指数（RI）；多焦视网膜电图（mfERG）分别对视网膜脱离患者的术前、术后进行检测，并以对侧正常眼作对照组。结果：CDI术前患眼与对照眼的CRA各项指标比较，差异无统计学意义。术后2wk视网膜脱离眼CRA的Vmax，Vmin均较术前降低，RI增高，差异有统计学意义（P<0.05）。视网膜脱离术后患者脱离区mfERG的a波、b波振幅密度均明显高于术前，潜伏期比手术前明显缩短，有统计学意义（P<0.05）。结论：通过mfERG，CDI的联合检测能及时了解视网膜脱离术后的视网膜复位情况及硅胶海绵垫压后CRA的血流情况，从而避免视网膜脱离术后视网膜部分复位不良，巩膜因缺血引起局部坏死等情况发生。

Application of multifocal electroretinogram and colour Doppler imaging in retinal detachment patients

AIM:To determine the prognosis by evaluating the retinal function and hemodynamic changes pre-and postoperation in retinal detachment patients, and investigate the clinical value of the techniques. METHODS: Central retinal arteries(CRA)were studied with color Doppler imaging (CDI)in 62 cases with unilateral rhegmatogenous retinal detachment, the fellow eyes served as control. The measured parameters included peak systolic velocity (Vmax), end diastolic velocity (Vmin) and resistance index(RI).The preoperative and postoperative retinas of retinal detachment were detected with multifocal electroretinogram (mfERG). RESULTS:There were no significant differences between the sick eyes and control eyes in the CDI parameters of CRA preoperatively. RI was significantly elevated (P<0.05), Vmax and Vmin were significantly declined (P<0.05) 2 weeks postoperation. The amplitude of a wave and b wave of mfERG were both significantly elevated in the detached area after retinal detachment operation(P<0.05). Compared with preoperation, the latent period decreased (P<0.05). CONCLUSION: Retinal reattachment and CRA hemodynamics are evaluated with combined mfERG and CDI examination, to avoid impaired reattachment and scleral ischemia after local silicone sponge implant.