原发性视网膜色素变性早期诊断临床探讨

A clinical study of early diagnosis of retinitis pigmentosa

目的探讨原发性视网膜色素变性（RP）早期诊断时检测手段的选择。方法选择4个偶发型RP患者家庭的子女11例在出现夜盲前进行视野和视网膜电图检测，比较这些检测手段对视网膜早期病变的敏感性。结果11例受检者的视网膜电图正常，2例30°视野结果可疑，加做60°视野后有1例出现以上方为主的视野缺损。结论对周边视网膜的早期病变，视野的敏感性高于视网膜电图。在进行RP早期诊断时，应首选全自动电脑视野仪进行60°视野检测，然后再进行30°视野检测和视网膜电图检测。

Objective To investigate the early diagnosis of retinitis pigmentosa （RP）. Methods Eleven persons from 4 families, without family history of night blind and sporadic RP, entered the study. All patients underwent fundus photograph, visual field detection and electroretinogram （ERG） examination. For those 30°visual field detection showed ＂Borderline＂ or ＂Outside normal limits＂, additional 60°visual field detection was taken to eliminate peripheral scotoma. In this way, detection sensitivity of visual field detection and ERG examination in early diagnosis of RP was compared. Results Fundus photograph and ERG examination showed normal in all the 11 persons but 30°visual field detection disclosed ＂Borderline＂ in two patients from different family. Additional 60° visual field detection revealed normal in one person but upper depression in another one. Conclusion Visual field detection, especially 60° visual field detection, is more sensitive than ERG examination in the detection of early damage in peripheral retina. In item election for early diagnosis of RP, 60° visual field detection is preferred primarily, followed by 30°visual field and ERG detection.