高度近视眼视功能状态与屈光度相关性的临床研究

Clinical research on the correlation of visual functional status and diopter in high myopia

目的:观察不同近视屈光度下,高度近视眼视功能状态的改变,寻找不同近视屈光度对高度近视眼功能、形态损害的相关早期客观敏感指征。方法:采用视野的中心低视力程序(LVC)和黄斑程序(M2,C08,TG2),以及视觉电生理系统中反映眼视功能状态的指标进行定性定量观察,包括单次视锥-视网膜电图(ERG)、30Hz闪烁ERG、P-VEP,多焦视网膜电图中一阶反应1、2环。结果:随近视屈光度的增加,视野的光敏感度(MS)下降;视觉电生理中PVEP、单次视锥细胞和30Hz闪烁b波、1环和2环振幅密度、1环b波振幅和2环a、b波振幅和潜时延长有下降(P<0.05);多元逐步回归分析提示,近视屈光度的数值与眼轴呈负相关关系,并与PVEP振幅呈正相关关系、与单次视锥b波潜时呈负相关关系。结论:视野、视觉电生理振幅可以较早检测到不同近视屈光度对视网膜功能的影响。

AIM： To observe the changes of visual functional status at different diopter degrees and to research the correlatively objective sensitive indications among diopter degrees, visual function and morphological damage at early stage in high myopia. METHODS： Low vision course （LVC） in vision center, macular course （M2, C08, TG2）, the index that can reflect the state of visual function in visual electrophysiology system were used to make qualitative and quantitative observation, including single cones-electroretinogram （ERG）, 30Hz flicker ERG, P-VEP, 1, 2 rings at first kernel response of multifocal ERG RESULTS： Vision light sensitivity was decreased with the increase of diopter. P-VEP in visual electrophysiology, single cones cells, b wave of 30Hz flicker ERG, amplitude density of 1 and 2 rings, b wave in 1 ring, and latencies of a, b wave in 2 ring were all decreased （P0.05）. The results of stepwise multiple regression analysis indicated that diopter value had negative correlation with axial and single cone b-wave latency, and had positive correlation with P-VEP amplitude. CONCLUSION： Vision, visual electrophysiology amplitude can detect the effect of different diopter on retinal function at early stage.