视网膜色素变性和先天性静止性夜盲的mERG检查

MERG findings of retinitis pigmentosa and congenital stationary night blindness

目的 比较视网膜色素变性 (RP)和先天性静止性夜盲 (CSNB)的多焦视网膜电图 (mERG)特征。方法 对 8例RP患者 14眼和CSNB患者 14眼进行mERG、传统ERG和视野检查。检测分别采用德国罗兰公司的RETI Scangamma型视觉电生理测试系统、日本光电株式会社的Neuropack Ⅱ视电生理仪和Topcon公司的SBP 2 0 2 0型全自动视野计进行。检查结果与 14只正常眼进行比较。MERG选择一级反应 ,分析 6个环的平均b波振幅 (平均反应密度 )和a、b波平均潜伏值一级视网膜后极部 3 0°范围的振幅和及潜伏值和。结果 RP组 1～ 6环各环的平均振幅与正常组比较明显下降 (P=0 0 0 11～ 0 0 0 0 1) ,而在CSNB组可见 1～ 2环b波振幅的轻度下降 ,但无统计学差异 (P =0 12 89,0 0 5 43 ) ,3～ 6环各环的b波振幅明显下降 (P =0 0 0 61,0 0 0 0 2 ,0 0 0 3 6)。两个患病组的各环a、b波平均潜伏值明显延长 (P =0 0 0 2 7～0 0 0 0 1) ,但较CSNB组的振幅反应异常程度严重 ,后极部 3 0°范围b波潜伏值和及各环a、b波潜伏值的延长在RP和CSNB组均明显延长。结论 MERG在RP和CSNB的诊断中具有不同的意义。RP的mERG特征主要以振幅介导的参数异常为主 。

ObjectiveTo compare multifocal electroretinogram (mERG) features of retinitis pigmentosa(RP)and congenital stationary night blindness(CSNB).MethodsMERG,scotopic ERG and perimetry were examined on 14 eyes of 8 cases with CSNB and 14 eyes of 9 cases with RP using RETI Scan mERG analysis system,Neuropack Ⅱ5100 electrophysiologic system and Topcon 2020 perimeter.All the results were compared to those of 14 normal eyes.The first order kenel responses of mERG was selected. The a,b amplitude and latency dominated responses from ring group and sum value were analyzed.ResultsThe average b amplitude densities of mERG in RP were the smallest from 1～6 rings.The differences of b amplitudes in each ring were statistically significant in comparison to normal eye ( P = 0.001 1 ～ 0 000 1 ). While in CSNB,a slightly reduced b average amplitude in 1～2 rings were found,but no statistical significance compared to normal eyes ( P = 0 128 9 , 0 054 3 ).However,a noticeble decrease of b amplitudes was seen from 3 th～6 th ring( P = 0 006 1 , 0 000 2 and 0 003 6 ).The a and b latencies were remarkedly delayed in CSNB and RP groups( P = 0 002 7 ～ 0 000 1 ).The b amplitudes and latency sum value were strikingly abnormal in both RP and CSNB groups.ConclusionThe mERG characters between RP and CSNB seem to vary.While the parameters dominated by amplitude are critical for the abnormality of mERG in RP,the parameters dominated by latency is more important for diagnosis of CSNB.