视网膜脱离复位后的视网膜电流图分析

Electroretinogram studies on the reattached retina

目的 应用视网膜电流图 (ERG)了解孔源性视网膜脱离 (RD)复位术后的视功能状态。方法 选择孔源性 RD患者 73例 (73只眼 ) ,均进行单次巩膜扣带术 ,术前及术后不同时期分别检测 ERG,随访 1～ 5月。结果 视网膜脱离后 ,ERG各指标振幅明显下降 ,潜伏期延迟。手术后 1月 ,ERG的 a波、b波振幅较术前明显回升 ,潜伏期在术后均延迟。随复位时间的延长 ,振幅无明显变化 ,潜伏期有缩短趋势。视网膜脱离复位后 ,最大反应振幅 b/a比值呈增加趋势。术后 1月 ,暗视视杆细胞反应振幅可恢复至对照组的 5 8.11%,30 Hz闪烁光反应的振幅则恢复至对照组的 45 .89%。结论 视网膜脱离复位后视功能在 1～ 2月内恢复最快且程度较大 ,视网膜内核层的恢复较光感受器层迅速 ,视杆系统较视锥系统恢复迅速且较完全 ,但随复位时间的延长增进缓慢。 ERG的不完全的恢复表明视网膜仍存在不可逆的损害。

Objective To investigate the visual function of reattched retina by electroretinogram(ERG).Methods ERG were recorded in 73 eyes in 73 in patients of rhegmatogenous retinal detachemnt before and after single scleral buckling surgery.No other ocular fundus diseases were found with them except myopia.The follow-up period was from 1 to 5 months.Results The mean amplitude of ERG were decreased and latency were delayed obviously in the eye of retinal detachment.After the scleral buckling surgery 1 months,amplitudes of a wave and b wave were increased but latencies were delayed.The amplitude of scotopic response was 58.11% of controls,but in flicker responses it was only 45.89% of controls.Amplitudes were no obvious changes and latencies had a tendency to become short later.The ratio of b/a was raised after surgery.Conclusion After retinal reattachment,it shows that the visual function improved rapidly in 1～2 months,but no significant progress thereafter.The recovery of inner nuclear layer was more rapid than the photoreceptor.The recovery of rods function was more rapid and complete than that of cones.Although the retina was reattached successfully,it shows reattached retina suffered irreversible injury and goes though incomplete recovery.