mfERG二阶Kernel反应对开角型青光眼的诊断价值

Significance of second-order kernel of mfERG in the diagnosis of open angle glaucoma

目的 观察并评估多焦视网膜电图(mfERG)二阶Kernel反应(SOK)在原发性开角型青光眼 (POAG)中的诊断价值。 方法 POAG患者 45例(78眼),分为早期、进展期、晚期。正常对照 24例 (48眼 )。对所有对象行mfERG检查,记录各环、象限的SOK的P1波反应密度和潜伏期,进行统计分析。 结果 正常对照随着离心率的增加, 5个环的SOK的P1波反应密度明显下降,潜伏期无明显变化; 4个象限的SOK的P1波反应密度及潜伏期无明显变化。POAG早期1环、2环及 4个象限SOK的P1波反应密度均比正常对照降低;进展期和晚期各环和各象限的SOK的P1波反应密度均比正常对照组降低;POAG各期之间的各环及各象限的SOK的P1波反应密度的差异具有显著性意义,潜伏期的差异均无显著性意义;POAG各期的各环及各象限的SOK的P1波潜伏期与正常对照相比差异均无显著性意义。SOK在POAG早期、进展期、晚期的敏感性依次为 74 19%、88 00%、100 00%,差异具有显著性意义。总体敏感性为 85 90%,特异性为 79 17%。 结论 mfERG的SOK的P1波反应密度可以较敏感地检测出POAG各期视功能的损害,对POAG的诊断尤其是早期诊断具有重要的临床意义。

Objective To study and evaluate the significance of second order kernel(SOK) of multifocal electroretinogram (mfERG) in the diagnosis of primary open angle glaucoma(POAG). Methods mfERG were recorded on 48 eyes of 24 normal controls and 78 eyes of 45 patients with early,advanced and late stages of POAG. The response densities and latencies of P 1 wave from 5 rings and 4 quadrants were analyzed. Results In the normal controls,the response densities of P 1 wave was reduced with the increase of eccentricity among 5 rings ( F =189 00, P <0 01),and the difference in the response densities was not statistically significant among 4 quadrants.The response density at the 1st,2nd and 4th quadrant was significantly lower in the early stage of POAG and was generally suppressed in all the rings and quadrants in the advanced and late stage of POAG ( P <0 05).Significant difference in response densities could be found among different stages of POAG from every ring and quadrant( P <0 05),and there was no remarkable changes in latencies between POAG and normal eye as well as among various stages of POAG.The sensitivity of SOK in different stage of POAG was 74 19%,88 0% and 100% respectively and the specificity 79 17%. Conclusion SOK exhibits different feature for every stage of POAG,and it is an useful tool for the diagnosis of POAG.