多焦视网膜电图用于年龄相关性黄斑变性视网膜功能的研究

The study of multifocal electroretinogram in analyzing the retinal function of age-related macular degeneration

目的应用多焦视网膜电流图(MERG)探讨年龄相关性黄斑变性视网膜不同部位的功能改变。方法选用年龄相关性黄斑变性(ARMD)的患者共27例54眼,其中干性ARMD11眼、湿性ARMD21眼,正常组22眼。所有患者均对其双眼进行检查。应用Veris视网膜功能分析仪对后极部视网膜的局部反应振幅和潜伏期进行检测,分别记录刺激总体、四个象限和6个环的潜伏期及反应振幅值,应用SPSS统计软件中两个独立样本的t检验进行统计学分析。结果在干性ARMD组与正常组、湿性ARMD与正常组及干性ARMD组与湿性ARMD组之间分别对1环(0.0°),2环(2.7°),3环(5.5°),4环(9.0°),5环(13.1°)和6环(18.7°)的反应振幅及潜伏期值进行统计学分析,发现:1、干性ARMD组与正常组MERG的6个环的反应振幅的比较:P值均大于0.05均无显著性差异;6个环的潜伏期的比较:P值均大于0.05均无显著性差异。2、湿性ARMD与正常组间MERG的6个环的反应振幅比较:P值均小于0.01均有非常显著性差异;6个环的潜伏期的比较:1环、5环、6环无显著性差异(P>0.05)、2环、3环、4环有显著性差异(P<0.05)。3、干性ARMD组与湿性ARMD组间MERG的6个环的反应振幅的比较:1环、3环、4环有非常显著性差异(P<0.01)、2环、5环、6环有显著性差异(P<0.05);6个环的潜伏期的比较:1环无显著性差异(P>0.05)、2环、5环、6环有显著性差异(P<0.05)、3环、4环有非常显著性差异(P<0.01)。结论研究证实,MERG能够对视网膜功能进行评价,对视网膜黄斑区功能异常进行初步定位[1],其作为一种无损伤的检查手段,在ARMD的早期诊断、随访观察及视网膜功能评价中具有一定的意义。

Objective To assess the application value of multifocal electroretinogram （MERG） in the function changes in different site of the retina of age - related macular degeneration. Methods 27 cases of patients which were clinically diagnosed as the ARMD were used. The local amplitudes and latencies of the posterior polar retina were measured in 11 eyes of dry typed ARMD, 21 eyes of wet typed ARMD and 22 normal eyes by Veris Retinal Function Analyzer （Multi- Focal ERG） using the same method. For all the patients, both eyes were examined. The amplitudes and latencies of stimulus overall, four quadrants and 6 rings were recorded and analyzed by the Two Independent Samples t test of the software SPSS for medical use. Results Acording to the examination result of MERG, statistically analyzed the amplitudes and latencies between dry typed ARMD and normal group, wet typed ARMD and normal group, dry typed ARMD and wet typed AR- MD by 1 ring （0.0°）, 2 ring （2.7°）, 3 ring （5.5°）, 4 ring （9.0°）, 5 ring （13.1°） and6 ring （18.7°） separatdy. The result is： 1 .The P values by amplitudes of the 6 rings between dry typed ARMD and normal group ： each ring has no significant difference （ P 〉 0.05 ） ; The P values by latencies of the 6 rings between dry typed ARMD and normal group ： each has no significant difference （ P〉0.05） 2 .The P values by amplitudes of the 6 rings between wet typed ARMD and normal group ： each has extremely significant difference （P〈0.01）; The P values by latencies of the 6 rings between wet typed ARMI） and normal group ： 1 ring, 5 ring, 6 ring has no significant difference （P〉0.05）, 2 ring, 3 ring, 4 ring has significant difference （P 〈0.05） 3. The P values by amplitudes of the 6 rings between dry typed ARMI） and wet typed ARMD： 1 ring, 3 ring, 4 ring has extremely significant difference （P〈0.01）, 2 ring, 5 ring, 6 ring has significant difference （P〈0.05）; The P values by latencies of the 6 rings between dry typed ARMD and wet typed ARMD ： 1 ring has no significant difference （P〉0.05）, 2 ring, 5 ring, 6 ring has significant difference （P〈 0.05 ）, 3 ring, 4 ring has extremely significant difference （ P 〈 0.01 ）. Conelusions The study proved that MERG can asses.s the retinal function, h can help to localize the site of abnormality initially. As a noninvasive examination method, it has certain significance in the early diagnosing , follow up study and retinal function assessment of ARMD.