多焦视网膜电图对钝伤性睫状体分离眼手术前后视功能的评价

Assessment of visual function with Multifocal Electroretinogram in patients with cyclodialysis cleft before and after surgery

目的 应用多焦视网膜电图研究钝伤性睫状体分离眼手术前后各部位视网膜功能,探讨睫状体分离眼视功能损害机制,为治疗及手术方法的选择与改进,预后的评估提供参考.方法 应用VERISscience TM4.2多焦电生理系统对43例钝伤性睫状体分离眼术前术后及对侧眼进行mfERG检测,以mfERG一阶反应N1波、P1波的振幅密度、潜时为分析指标,对不同视网膜区域包括6个离心度,中心凹、黄斑区、黄斑外区进行检测.对视力与mfERG的关系进行分析.结果 钝伤性睫状体分离组患眼手术前后的mfERG比较：N1、P1波振幅密度术后较术前明显提高,术后潜时较术前缩短,在6个环差异均有统计学意义（P〈0.01）.钝伤性睫状体分离组患眼术后与对侧眼的mfERG比较：患眼在6个环的N1、P1波振幅密度较对侧眼降低,潜时延长,差异均有统计学意义（P〈0.01）.彩色三维立体地形图直观的显示与黄斑病变相对应的功能异常.术后视力与术前mfERG无明显相关关系（P〉0.05）,术前视力与术后mfERG存在等级相关（P〈0.05）.结论 mfERG能对钝伤性睫状体分离眼视网膜功能进行定位定量测量.

Objective In order to give a convenient criterion to select and improve the operation skills as well as provide a useful reference to prognosis, multifocal electroretinalgram （mfERG） was taken to study the various function of the retina in different locations and the mechanism of the damage to the visual function of the cyclodialysis cleft before and after surgery .Methods The mfERG of 43 cyclodialysis cleft eyes before and after surgery and the fellow eyes were recorded by VERISE Science TM4.2 multifocal visual evoked response imaging system.Based on the first order kernel of N1 and P1 waves, changes in different area including the different eccentricities, central foveal, macular area and extra-macular area were investigated.Results The comparison of mfERG of cyclodialysis cleft eyes before and after surgery showed that the amplitude of P1 and Nl waves increased in six rings after the operation.The latencies also shortened.The differences in six rings were statistically significant （P〈0.01 ）.The comparison of mfERG of the affected eyes of cyclodialysis cleft eyes after surgery and the fellow eyes, the latencies of N1 and P1 wave in six rings were significantly delayed （P〈0.01 ）and their amplitudes in 1-6 rings markedly decreased in the group of cyclodialysis cleft eyes （P〈0. 01）.Conclusions mfERG can provide the quantificational and orientational detection for the visual function of the eyes with the cyclodialysis cleft.