Vogt—Koyanagi—Harada综合征多焦视网膜电图研究

The study of multifocal electroretinogram in Vogt-Koyanagi-Harada syndrome

目的观察VKH（Vogt—Koyanagi—Harada，VKH）综合征急性期与恢复期后极部视网膜功能的变化特点。方法对15例（30只眼）VKH综合征患者的急性期与恢复期进行mfERG测定，并与正常对照比较。结果急性期VKH综合征患者各环mfERGN1、P1波振幅均有降低、多数环峰时延长，变化有统计学意义（P〈0．05）；各区域振幅降低幅度不同，以中心凹1环处降低最为严重，P1波振幅仅有正常对照的25％，随离心度增加，振幅降低逐渐减轻；与急性期相比较，恢复期1-3环mfERG振幅提高（P〈0．05），4-6环振幅改变无统计学意义。与正常对照相比较，恢复期各环振幅降低仍有统计学意义；发生渗出性视网膜脱离与否，两组患者之间mfERG差异无统计学意义（1P〉0．05）。结论VKH对后极部视网膜功能有严重影响，即使治疗后视力恢复较理想，视网膜功能仍有较大程度损害。黄斑是治疗前后功能变化较大的部位。

Objective To observe the features of posterior retinal function in acute and recovery stages of VKH syndrome. Methods The mfERG was recorded in 15 VKH cases （30 eyes） both in acute and recovery stage, the results were also compared with normal control. Results In the acute stage, the amplitudes of N1, P1 waves were significantly decreased, as well as the implicit times were significantly prolonged in all the 6 rings, except implicit times of P1 in 5 and 6 ring （P〈0.05）. These abnormalities had a regional difference, the most decreased part was fovea （ 1 ring）. The amplitude of P1 wave at 1 ring was only 25% of normal. There was a tendency that the abnormal degree of mfERG was lessened as the acentric degree increased. In the recovery stage, the amplitudes inside the 3 rings were remarkably increased （P〈0.05）, no significant amplitude changed as compared with acute stage outside the 3 rings. In this stage, the amplitudes of all rings were still remained great difference with normal control. There were no significant differences of mfERG date in acute VKH with or without exudative retinal detachment （P〉0.05）. Conclusions VKH has a serious damage to the posterior retinal ftmction, even satisfied visual acuities acquired after proper and prompt treatment. Macula is the part with great functional variation before and after medication.