视网膜电图在早产儿视网膜病变激光术后视网膜功能评价中的应用

Electroretinogram in retinal functional evaluation after laser surgery in retinopathy of premature

目的应用视网膜电图(electroretinogram,ERG)评价早产儿视网膜病变(retinopathy of premature,ROP)激光术后视网膜功能的变化。方法选取2011年1月至2012年12月在我院行激光光凝术的ROP患儿30例(60眼)为观察组,另选取同期视网膜发育正常的健康早产儿30例(60眼)为对照组,记录激光术后6个月的暗适应与明适应ERG,并对两组结果进行统计比较。结果观察组视杆反应b波振幅为(131.47±36.20)μV,对照组为(149.33±40.14)μV,差异有统计学意义(P<0.05);观察组最大混合反应a波、b波振幅分别为(96.52±23.71)μV、(222.76±53.44)μV,对照组分别为(109.85±23.17)μV、(260.44±52.28)μV,差异均有统计学意义(均为P<0.05);观察组振荡电位峰值为(37.71±22.23)μV,对照组为(49.70±32.24)μV,差异有统计学意义(P<0.05)。观察组视杆反应b波及最大混合反应a波、b波潜伏期与对照组差异均无统计学意义(均为P>0.05)。观察组视锥反应a波、b波振幅与对照组差异均无统计学意义(均为P>0.05),观察组视锥反应a波、b波潜伏期与对照组差异也均无统计学意义(均为P>0.05)。结论经过激光光凝术治疗,ROP患儿视网膜视锥细胞功能发育与正常早产儿没有差别,而视杆细胞功能发育略差。

Objective To evaluate the retinal function changes after laser surgery in patients with retinopathy of premature （ROP） by electroretinogram （ ERG ）. Methods A total of 30 cases （ 60 eyes） underwent laser photocoagtflation in our hospital during January 2011 and December 2012 were chosen as observation group, and another 30 healthy premature cases（60 eyes）with normal retina were selected as control group, the photopic and scotopic ERG at 6 months after laser surgery were recorded, and the results between two groups were compared and analyzed. Results The amplitude of b wave in rod reaction in observation group and control group were（ 131.47 ±36.20） μN and（ 148.33 ±40.14 ） μV, respectively （ P 〈 0.05 ）. The amplitude of a, b wave in maximum mixed reaction in observation group were（95.52 ±25.71 ） μV and（222.76 ±53.44） μV, respectively, which in control group were（ 109.85 ±23.17 ）μV and（ 260.44 ±52.28 ） μV,respectively（ all P 〈 0.05 ）. The peak of oscillatory potentials in observation group and control group were（37.71 ±22.23） μV and（49.70±32.24） μV, respectively（P 〈 0.05）. There was no statistical difference in latency of a, b wave in rod reaction and maximum mixed reaction between two groups（ all P 〉 0.05 ）. There was no statistical difference in latency and amplitude of a,b wave in cone reaction between two groups（ all P 〉 0.05 ）. Conclusion After laser photocoagulation treatment, the retinal cone cell functional development has no difference with normal premature infants, but the rod cell functional development is shghtly worsen.