弱视患者多焦视网膜电图的研究

Investigation of multifocal electroretinogram in amblyo pia

目的 探讨弱视患者多焦视网膜电图 (mfERG)的改变和视网膜的损害。方法 对 2 8例屈光参差性弱视患者 (A组 )、2 5例斜视性弱视患者 (B组 )、14例屈光不正性弱视患者 (C组 )行mfERG检测 ,记录总体和不同视野区域的一阶、二阶反应N1波、P1波的振幅密度和潜时 ,并与正常对照者 (D组 )进行比较。结果 A、B、C组mfERG的一阶反应P1波、N1波和二阶反应P1波的振幅密度均降低 (P <0 0 5 ) ,且这种改变在视野中央明显 ,随偏心度的增加而减少。 4组mfERG均表现颞侧视野一阶反应P1波、N1波振幅密度较鼻侧视野降低 ,且潜时延长 (P <0 0 5 ) ;上方视野二阶反应P1波振幅密度均低于下方视野 (P <0 0 5 ) ,其余指标上、下方视野差异无显著意义 (P >0 .0 5 )。A、B、C组各阶反应波的潜时与D组比较 ,差异均无显著意义 (P >0 0 5 )。弱视患者视力与mfERG指标之间无线性相关关系 (P >0 0 5 )。A、B组中健眼mfERG指标与患眼比较 ,差异均有显著意义 (P <0 0 5 ) ;与D组比较 ,差异无显著意义 (P >0 0 5 )。结论 弱视患者mfERG有明显改变 ,提示弱视眼视网膜神经节细胞受损 ,但神经信息的传递无延长。

Objective To investigate the changes of the multifocal electroretinogram (mfERG) in amblyopic eyes. Methods The mfERG of 28 anisometropic amblyopic cases (28 eyes), 25 strabismic amblyopic cases (25 eyes) , 14 isometropic amblyopic cases (28 eyes) and 54 normal control eyes were tested. Results The N 1 wave and P 1 wave amplitude densities of mfERG first order kernel and the P 1 wave amplitude densities of second order kernel in amblyopic eyes were significa ntly attenuated in the central region of the visual field (P<0.05), and these phe nomena gradually reduced with the increase of the eccentricity. The N 1 wave and P 1 wave amplitude densities of mfERG first order kernel at the temporal visual field wer e smaller than that of the nasal visual field, and the latencies were delayed at the tempo ral visual field in all groups (P<0.05). The P 1 wave amplitude densities of mfERG se cond order kernel at the upper visual field were smaller than that of the lower visual fiel d in all groups (P<0.05), and no significant differences could be detected in other indexes between the upper visual field and the lower visual field (P>0.05). There w as no significant difference in latencies of mfERG between the amblyopic eyes and cont rol eyes (P>0.05). No significant difference of mfERG was found among the three type s of amblyopic eyes. In the amblyopic eyes, there was no linear correlation between v isual acuity eyes and various indexes of mfERG (P>0.05). There was significant di fference in mfERG between the amblyopic eyes and contralateral eyes (P<0.05), but there was no significant difference between the contralateral eyes and the control eyes (P >0.05). Conclusions The X ganglion cells in the retina of amblyop ic eyes are abnormal, but the visual information transmitting time in the retina was normal in the amblyopic e yes. (Chin J Ophthalmol,2004,40:655-662)