原发性开角型青光眼黄斑区视网膜厚度与多焦视网膜电图变化的关系

Relationship between the thickness of macula and changes of mutilfocal electroretinography in primary open angle glaucoma

目的探讨原发性开角型青光眼(POAG)患者黄斑区视网膜厚度与相对应的视网膜功能改变的关系。方法对24例(43只眼)POAG患者的早期、进展期和晚期患眼进行光学相干断层扫描(OCT)及多焦视网膜电图(ERG)的检查。所得数据应用SPSS统计分析软件进行处理,并做线性相关分析。结果早期的开角型青光眼患者中OCT所测黄斑区视网膜厚度与mERG1环b波潜伏期有显著性负相关(γ=-0.72,P<0.05,t=2.936);晚期POAG患者中OCT所测黄斑区视网膜厚度与mERG2,3环b波潜伏期有显著性负相关(γ=-0.666,γ=-0.702,t=2.676,t=2.956,P<0.05);对早期,进展期和晚期的开角型青光眼患者OCT所测黄斑区厚度进行比较,显示早期OCT黄斑厚度与晚期相比有极显著性差异,P<0.01;进展期与晚期相比有显著性差异,P<0.05,F=5.018。结论POAG患者黄斑区神经上皮厚度的改变影响了黄斑区局部视网膜的功能状态,主要表现为与mERG的b波潜伏期有一定相关性;早期POAG患者眼底视网膜组织形态学上无明显改变时,视网膜功能已经有了改变,OCT与mERG检查对于POAG临床的早期诊断与治疗具有指导性的意义。

Objective To investigate the relationship between the changes of the thickness of retina in macula and the abnormalities in mutilfocal electroretinography （ mERG ） in primary open angle glaucoma （POAG）. Methods mERG and optical coherence tomography （OCT） examination were performed in 24patients （ 43 eyes ） with POAG （ phase Ⅰ - Ⅲ ）. The data were processed with software SPSS and line relation analysis was done. Results The relationship between the retina thickness of the macula and the latent period of the b wave of the first ring in mERG is negative relation for the patients with early POAG （ γ = - 0. 72, t = 2. 936, P 〈 0.05 ） ; for the latter patients with POAG, the relationship between the macula retina thickness and the latem period of the b wave of the second and third ring in mERG is negative relationC γ2 = - 0.666, γ3 = - 0.702, t 2 = 2.676, t 3 = 2. 956, P 〈 0.05）. It is significant difference for the retina thickness of the patients with POAG by OCT, between in early and latter stage（ P 〈 0.01 ）, and between in developing and latter stage（ F = 5. 018, P 〈 0.05 ）. Conclusion The changes of the thickness of neuroretina in mucula may affect the local retina function in macula,which may be revealed by the reduction of response densities in mERG in patients with primary open angle glaucoma.