酒精中毒眼部损害视觉电生理检测

Visual electrophysiology for alcoholic ocular changes

目的 对急慢性酒精中毒眼部损害者进行视觉电生理观察，了解酒精中毒性视力损害的机制。方法 对急性酒精中毒眼部损害者３例６眼和慢性中毒者６例１２眼行暗适应视网膜电图（ＥＲＧ），视觉诱发电位（ＶＥＰ）和视野，眼底荧光造影等检查并进行 １月～２年的随访。结果 显示急性中毒３例６眼中暗适应 ＥＲＧ正常，Ｆ－ＶＥＰ或 Ｐ－ＶＥＰ Ｐ１００波严重下降，２例４眼治疗后完全恢复（６６．７％），ｌ例２眼成为永久性损害。经证实未恢复的１例２眼呈弥漫性色素上皮损害，眼底荧光血管造影显示全部眼底的透见荧光和色素游离的遮蔽荧光相间造影像，黄斑区视网膜尤甚。经２年随访无明显改善。慢性中毒６例 １２眼有不同程度的视野缺损，暗适应 ＥＲＧａ，ｂ波、Ｐ－ＶＥＰ Ｐ１００波潜伏值均出现永久性异常，眼底荧光血管造影证实视网膜后极部数簇遮蔽荧光和透见荧光像。结论 认为急慢性酒精中毒可首先造成视网膜色素上皮的弥漫性或黄斑区的损害，而视神经损伤可能发生于上述改变之后；视觉电生理检测可对其损害提供可靠的诊断和跟踪随访依据。

Objective To observe and follow-up the ocular changes of acute or chronic alcoholic with visual electrophysiologic test. Methods Scotopic ERG,P-or F-VEP and perimetry, fluorescine fundus angiography examination were performed for 18 eyes (9 cases) with alcoholic ocular changes. Results 6 eyes (3 cases) presented normal ERG and amplitudes reduce of F-or P-VEP P100 in acute alcoholic,4 eyes(2 eyes) of them returned to normal after treatment(66. 7% ) and 2 eyes(l cases) showed permanent changes. Visual field deficiency, irreversible abnormalitis of a,b wave amplitudes and P-VEP P100 latency were found in chronic alcoholics. Conclusion Acute or chronic alcoholism can damage retinal pigment layer, ERG and VEP can provide useful basis.