年龄相关性黄斑变性多焦视网膜电图一阶响应研究结果及分析

Study on mfERG FOK of age-related macular degeneration

目的:探讨记录年龄相关性黄斑变性(age-related macular degeneration,AMD)患者和正常人的多焦视网膜电图(multifocal electroretinogram,mfERG)的方法,分析mfER在AMD中的诊断价值。方法:RETIscan(Version 3.11)设备检测记录66例患者(分为干、湿两型)和13例正常人mfERG6个环反应特征。结果:干性组P1波1～3环、N1波1环反应密度下降(P<0.05),P1波1环、N1波2,3,5环潜伏期延迟(P<0.05);湿性组各波各环反应密度、潜伏期均下降/延迟,与干性组比较,P1波1～4环、N1波2,3环反应密度下降(P<0.05),P1波1～5环、N1波1～3环潜伏期延迟(P<0.05);湿性对侧健眼组1,2环P1反应密度降低(P<0.05)。单眼湿性对侧干性眼组与干性组比较无差异。结论:P1波1～3环、N1波1环反应密度、P1波1环、N1波2,3,5环潜伏期可考虑做为干性组AMD视网膜功能变化的敏感指标。P1,N1波1～4环、N1波2,3环反应密度、P1波1～5环、N1波1～3环潜伏期可能反应湿性组AMD视网膜后极部变化情况。单眼湿性AMD患者若对侧为健眼则可能发生AMD,若对侧为干性眼,则可能不会加重其病情进展。

AIM： To investigate the diagnostic value of multifocal electroretinography（mfERG） in Age-related macular degeneration （AMD）. ·METHOD： MfERG was recorded in 66 AMD patients and 13 healthy （people） with RETI scan （Version 3.11） system. The P 1 and N 1 wave components were analyzed.·RESULTS： Response densities of P1 wave in ring 1-3 and N1 wave in ring 1 were decreased and latencies of P1 wave in ring 1, N1 wave in ring 2, 3, 5 were delayed in dry-form group （P0.05）. Response densities decreased and latencies delayed in all rings in wet-form group, meanwhile, compared with dry-form group, response densities of P1 wave in ring 1-4 and N1 wave in ring 2-3 were decreased（P0.05） and latencies of P1 wave in ring 5 and N1 wave in ring 1-3 were delayed （P0.05）. Response densities in ring 1-2 of the asymptomatic fellow eyes of wet-form group were decreased compared with the control and asymptomatic fellow eyes of dry form groups（P0.05）. No changes were observed between one eye in dry-form with contralateral wet-form group and dry-form group（P0.05）.·CONCLUSION： Response density in ring 1-3 of P1 wave and ring 1 of N1 wave, latency in ring 1 of P1 wave and ring 2,3,5 of N1 wave may be a sensitive index of dry-form AMD. Response density in ring 1-4 of P1 wave and ring 2-3 of N1 wave, latency in ring 1-5 of P1 wave and ring 1-3 of N1 wave may reflex functional changes in posterior pole of wet-form AMD. The asymptomatic fellow eyes of wet AMD are vulnerable to become dry AMD, while no influence on dry-form eyes with contrala-teral wet-form AMD in this study.