用m-ERG诊断原发性开角型青光眼的初步观察

目的 应用多焦视网膜电图(m—ERG)一阶kernel反应(FOK)和二阶kernel反应(SOK)对原发性开角型青光眼进行了初步观察。方法 采用德国罗兰多膀视觉电生理检查系统(RETIscan 3．15 version)和瑞士 OCTOPUSl01电脑视野分析仪。检测了33只正常眼和早期、中期、晚期青光眼共42眼和高眼压症(可疑青光眼)16眼。记录了m—ERG的FOK和SOK的P、N波的振幅和峰时4个参数。将原始数据转入SPSS 8．0软件进行统计学处理。结果 (1)从可疑青光眼组到早、中、晚期青光眼组，FOK和SOK的P波、N波振幅逐渐下降，P波、N波峰时逐渐延长；(2)在总和反应中，FOK的P波振幅和SOK的N波振幅在早、中、晚期青光眼组与正常对照组间差异有显著性(严＜0．05)；(3)FOK的N波峰时和SOK的P波峰时，在中、晚期青光眼组与正常对照组间差异有显著性(P＜0．05)；(4)可疑青光眼组与正常对照组在象限反应中，SOK的鼻上象限的P波振幅，鼻下、颞下象限的N波振幅与正常对照组之间差异有显著性(P＜0．05)。结论 FOK和SOK是检测青光眼的一种敏感方法，尤其是象限反应，在青光眼视野损害之前就能敏感地出现异常。

Observation of primary open-angle glaucoma diagonosed by m-ERG

Objective To observe the primary open angle glaucoma (POAG) applying with the m ERG first order kernel (FOK) and the second order kernel (SOK). MethodsWe used the multi focal electrophysiological examination system (RETIscan 3.15 version) and the OCTOPUS101 computer visual field analysis appliance. Examined 33 normal subject eyes and selected 42 eyes of glaucoma and 16 eyes of ocular hypertension (suspected glaucoma), dividing into early, middle and late stage glaucoma. Four parameters of P and N wave of the amplitude and latency of FOK and SOK were recorded. The SPSS8.0 software of statistics analyzed the primary data.Results (1) From the suspected to the early stage, middle stage and late stage glaucoma groups, the amplitude of P wave and N wave gradually decreased, the latency of P wave and N wave gradually prolonged; (2) In sum reaction, the amplitude of P wave in FOK and amplitude of N wave in SOK was significantly different in the early stage, middle stage and late stage glaucoma groups, normal collative group ( P <0.05); (3) The latency of N wave in FOK and the latency of P wave in SOK was significantly different between the middle stage and late stage glaucoma and normal collative group ( P <0.05);(4) In the quadrantal reactions between the suspected glaucoma group and normal collative group, it was significantly different in the superior nasal quadrantal P wave amplitude in SOK and interior nasal , interior temporal quadrantal N wave amplitude( P <0.05).Conclusion FOK and SOK is a more sensitive method in examining glaucoma, especially their quadrantal reactions, than the abnormality of the visual field damage can manifest.