视网膜脱离眼的黄斑局部视网膜电图

Macular local electroretinogram in retinal detachment

:目的 :通过对视网膜脱离 (retinaldetachment ,RD)眼的局部视网膜电图 (localelectroretinogram ,LERG)记录分析 ,进一步了解RD眼黄斑部光感受器细胞与第二级神经元功能异常的情况 ,并对LERG与视功能预后的关系进行探讨。方法 :12 0例RD患者 12 8只眼的LERG被记录分析 ,应用手提眼底镜式局部刺激器通过放大的瞳孔直视眼底监控固视状况 ,记录a波、b波与OPs各项成分。结果 :与对照组相比 ,LERG的a波、b波与OPs的异常率 :在 <1周组分别为 15 %、15 %与 10 % ;在1～ 2周组为 35 %、45 %与 5 0 % ;在 2～ 4周组为 46 86 %、5 6 2 5 %与 6 2 5 % ;在 4～ 8周组为 76 %、84%与 88% ;在 8周以上组则为 86 96 %、91 30 %与 95 5 6 %。a波与b波在脱离时间 <1周组与对照组无明显差异 ;1～ 2周组a波与b波开始有明显降低 (P <0 0 5 ) ,随着发病时间的延迟 ,b波的下降较a波更为迅速 ,在 2～ 4周则具有高度显著意义 (P <0 0 1) ;b/a值在早期RP病变表现正常或轻度异常 ,伴随病程增加有降低趋势 ,在 4～ 8周组即出现显著性降低 (P <0 0 5 )。在眼底镜下黄斑部脱离的 48只眼中 ,LERG各项成分的降低均有统计学意义 ;而在眼底镜下观测不到黄斑脱离的 80只眼中 ,b波、OPs与OP2子波振幅也表现异常 (P <0 0 5 )。

HT5”SS]Objective:To understand the sites and characteristics of macular dysfunction in retinal detachment(RD)by evaluating components of local electroretinogram(LERG) Methods:LERG were recorded in 128 eyes of 120 patients of retinal detachment by using a hand held stimulator with direct visualization of the fundus through dilated pupils Results:Compared to controls,the patients showed losses of a wave,b wave and oscillatory potentials(OPs)amplitudes The abnormality ratios of a wave and OPs in RD affected time:<1 week were 15%,15% and 10%;1～2 weeks were 35%,45% and 50%;2～4weeks were 46 86%,56 25% and 62 5%;4～8 weeks were 76%,84% and 88%;>8 weeks were 86 96%,91 30% and 95 56% respectively On average,b wave decreased quicker than a wave,and b/a tended to decrease with the course of disease The results show a wave,b wave and OPs decreased significantly in the 48 RD eyes with macular detachment(P<0 05),wnile amplitudes of b wave,OPs and OP2 also decreased obviously in the other eyes(P<0 05) Conclusion:The results suggest that in the eyes with retinal detachment dysfunctions in both receptoral and postreceptoral sites contribute to macular dysfunction In eyes without macular it also shows macular dysfunction,but the level of macular dysfunctions in eyes with macular detachment is greater than those without macular detachment It would be of clinical value to obtain a a wave and b wave ratio in order to assess the disturbance in the different site of macula In our opinion,LERG is an important indicator for prognosis of the functional recovery of the attached eye after corrective surgery [HT5”H]