中心性浆液性脉络膜视网膜病变的电生理功能检查和医学鉴定

目的 探索视觉电生理学检查技术在中心性浆液性脉络膜视网膜病变医学鉴定的作用。方法 采用图形视觉诱发电位（PVEP）、视网膜电图（ERG）和多焦点视网膜电图（mERG)检查技术对临床诊断为中心性浆液性脉络膜视网膜病变的16例病例（包括飞行员和飞行学员各1例）进行功能评定，并与荧光血管造影和常规的眼科检查方法比较。结果 荧光造影证实11例（13眼）为急性中心性浆液性视网膜脉络膜病变，其PVEP的P100波幅值降低，峰时值均无明显改变；传统ERG 5种反应没有明显改变。mERG波幅值明显降低，降低区域与荧光血管所显示的病变范围相对应。没有荧光渗漏，只表现为色素脱失和色素紊乱的陈旧性黄斑病变者mERG仍可以表现为异常。结论 mERG能够对视网膜黄斑区病变进行客观反映，视觉电生理检查技术在航空临床医学鉴定中具有重要价值。

Visual electrophysiological testing and medical assessment of central serous chorioretinopathy

Objective To investigate the role of visual electrophysiological testing in diagnosis and assessment of central serous chorioretinopathy (CSC). Methods Sixteen CSC cases (including a pilot and a flying cadet) were examined by fluorescein angiography pattern visual evoked potential (PVEP), electroretinogram (ERG) and multifocal electroretinogram (mERG). Results Eleven cases (13 eyes) of acute CSC showed abnormal P 100 amplitude of PVEP, but the implicit time was normal. The scotopic, photopic ERG and OPs waves did not show obvious changes. The mERG amplitude of affected eyes reduced significantly,corresponding to fluorescein angiography examined. In some cases without hyperfluorescence just showing pigment loss in macula area, abnormal mERG waves were still found. Conclusions mERG could objectively reflect pathological changes of macular area in CSC. Visual electrophysiological testing technique is valuable for aeromedical assessment of CSC cases.