影响视网膜脱离患者视网膜功能的因素

Evaluation of the factors impacting on the function in retinal detachment

目的:评价视网膜脱离患者年龄、病程、视网膜脱离面积、黄斑脱离情况等因素对视网膜功能的影响。方法:将孔源性视网膜脱离(retinal detachment,RD)188例189眼的患者年龄、病程、视网膜脱离面积、黄斑脱离情况、视力与视网膜脱离眼的fERG和mfERG各指标进行相关分析。结果:影响RD眼fERG和mfERG的主要因素是脱离面积、黄斑脱离和视力。以|γ|>0.4,且P≤0.05判定为有相关性。脱离面积与明视和暗适应最大反应ERG a、b波幅值,30Hz闪烁光幅值,OPs波数和幅值负相关;与mfERG象限野P1波幅值密度、幅值负相关。相关系数最高者为fERG暗适应最大反应b波幅值(γ=-0.704)。黄斑脱离与明视和暗适应最大反应ERG b波幅值,30Hz闪烁光ERG幅值负相关;与mfERG环形野环1的P1波幅值密度、幅值负相关,与mfERG象限野P1波幅值密度负相关,相关系数最高者为mfERG环形野环1的P1波幅值(γ=-0.584)。视力与明视和暗适应最大反应a、b波幅值,30Hz闪烁光幅值,OPs子波数和幅值正相关;与mfERG环形野环1的P1波幅值密度、幅值正相关,相关系数最高者为30Hz闪烁光ERG幅值(γ=0.597)。RD眼的fERG异常率最高者为暗适应最大反应ERG b波幅值,异常率为71.3%,视网膜脱离象限野mfERG异常率最高者为P1波幅值,异常率为85.3%。结论:影响RD患者视网膜功能的重要因素是脱离面积和黄斑脱离情况。RD眼对视网膜功能异常反应的mfERG对视网膜功能异常反应的敏感性高于fERG。

AIM： To evaluate the effect of ages, course of retinal detachment （RD）, amplitude of detachment, macular detachment and other factors on retina function. METHODS： A total of 188 cases （189 eyes） with RD were included to analyze their fERG, mfERG, ages, course of RD,amplitude of detachment and macular detachment. RESULTS： The amplitude of detachment, macular detachment and vision were mainly risk factors for RD patients＇fERG and mfERG. The standard of dependablity was ｜γ｜ 〉0.4 and P≤0.05. The amplitude of detachment was significantly negative correlated with amplitude value of a-wave and b-wave in photopic ERG and scotopic ERG, amplitude values of 30Hz flare, and amount and amplitude value of oscillatory potentials （OPs）. And also it was significantly negative correlated with Pl-wave amplitude density and value in quadrantal mfERG. The maximal correlation coefficient was b-wave amplitude value in scotopic fERG （ y = -0. 704）. The macular detachment was significantly negative correlated with b-wave amplitude value in photopic ERG and scotopic ERG, amplitude value of 30Hz flare, Pl-wave amplitude density and value in 1 ring mfERG and Pl-wave amplitude density in quadrantal mfERG. The maximal correlation coefficient was Pl-wave amplitude value in 1 ring mfERG（γ=-0. 584）. The vision was significantly positive correlated with amplitude of amplitude values of a-wave and b-wave in photopic ERG and scotopic ERG, amplitude values of 30HZ flare, amount and amplitude value of Ops and Pl-wave amplitude density and value in 1 ring mfERG. The maximal correlation coefficient was amplitude value of 30HZ flare ERG （γ = 0. 597）. The highest abnormal rate of RD patients＇fERG was b-wave amplitude value in scotopic fERG （71.3%）. The highest abnormal rate of quadrantal mfERG was Pl-wave amplitude value （85.3%）. CONCLUSION： The mainly risk factors for RD patients are amplitude of detachment and macular detachment. The mfERG are more sensitive than fERG in RD patients. r