不同多焦视网膜电图系统在评估视网膜功能上的比较研究

Comparison of the retinal function in different multifocal retinal system

目的探讨VERIS和RETI两种多焦视网膜电图(mf ERG)系统在评估视网膜功能上的差异及相关性。方法收集2012年5月至2014年5月在辽宁省沈阳爱尔眼科医院视功能科就诊的60例(60只眼)受检者的临床资料,进行回顾性分析。VERIS系统使用BA电极,RETI系统使用BA或DTL电极,分别测量36例(36只眼)正常眼的mf ERG,并进行相关性分析;VERIS系统和RETI系统均使用BA电极分别测量24例(24只眼)黄斑水肿眼的mf ERG,并进行分析。VERIS系统和RETI系统测量正常眼N1波和P1波振幅密度及波潜伏期的相关性时采用Pearson相关性分析进行比较;测量黄斑水肿眼N1波和P1波振幅密度和波潜伏期的相关性以均数±标准差(x珋±s)的形式表示,并采用独立样本t检验的方法进行比较。结果正常眼:VERIS系统和RETI系统均使用BA电极时,N1波振幅密度在2、3、4及5环的相关性比较,差异有统计学意义(r=0.62,0.64,0.69,0.70;P<0.05);VERIS系统使用BA电极而RETI系统使用DTL电极时,N1波振幅密度在2、4及5环的相关性比较,差异有统计学意义(r=0.61,0.59,0.51;P<0.05);RETI系统分别使用BA和DTL电极时,N1波振幅密度在1环的相关性比较,差异有统计学意义(r=0.67,P<0.05)。VERIS系统和RETI系统均使用BA电极时,P1波振幅密度在各环的相关性比较,差异有统计学意义(r=0.61,0.84,0.68,0.77,0.69;P<0.05);VERIS系统使用BA电极而RETI使用DTL电极时,P1波振幅密度在1环及2环的相关性比较,差异有统计学意义(r=0.64,0.58;P<0.05);RETI系统分别使用BA和DTL电极时,P1波振幅密度在2环的相关性比较,差异有统计学意义(r=0.60,P<0.05)。VERIS系统和RETI系统均使用BA电极时,N1波潜伏期在2环的相关性比较,差异有统计学意义(r=0.62,P<0.05);VERIS系统使用BA电极而RETI系统使用DTL电极时,N1波潜伏期在各环的相关性比较,差异无统计学意义(r=-0.03,-0.05,-0.21,-0.08,0.32;P>0.05);RETI系统分别使用BA和DTL电极时,N1波潜伏期在各环的相关性比较,差异无统计学意义(r=-0.03,0.10,0.21,0.30,0.17;P>0.05)。VERIS系统和RETI系统均使用BA电极时,P1波潜伏期在2、3及5环的相关性比较,差异有统计学意义(r=0.53,0.76,0.65;P<0.05);VERIS使用BA电极而RETI使用DTL电极时,P1波潜伏期在5环的相关性比较,差异有统计学意义(r=0.58,P<0.05);RETI系统分别使用BA和RETI电极时,P1波潜伏期在各环的相关性比较,差异有统计意义(r=0.70,0.64,0.60,0.57,0.65;P<0.05)。黄斑水肿眼:VERIS系统使用BA电极时1环的N1波和P1波振幅密度分别为(27.67±2.31)n V/deg2和(70.32±22.35)n V/deg2;RETI系统使用BA电极时1环的N1波和P1波振幅密度分别为(21.35±2.64)n V/deg2和(62.42±18.54)n V/deg2,两种系统在1环的N1波振幅密度比较,差异有统计学意义(t=2.38,P<0.05);P1波振幅密度比较,差异有统计学意义(t=2.01,P<0.05)。VERIS系统使用BA电极时2环的N1波和P1波振幅密度分别为(20.47±2.01)n V/deg2和(47.63±12.43)n V/deg2;RETI系统使用BA电极时2环的N1波和P1波振幅密度分别为(18.63±2.41)n V/deg2和(37.47±13.34)n V/deg2,两种系统在2环的N1波振幅密度比较,差异无统计学意义(t=-0.32,P>0.05);P1波振幅密度比较,差异有统计学意义(t=3.52,P<0.05)。VERIS系统使用BA电极时1环的N1波和P1波潜伏期分别为(21.14±4.24)n V/deg2和(40.35±4.55)n V/deg2;RETI系统使用BA电极时1环的N1波和P1波潜伏期分别为(20.35±3.35)n V/deg2和(32.22±5.74)n V/deg2,两种系统在1环的N1波潜伏期比较,差异无统计学意义(t=0.93,P>0.05);P1波潜伏期比较,差异有统计学意义(t=3.57,P<0.05)。VERIS系统使用BA电极时2环的N1波和P1波潜伏期分别为(17.54±4.54)n V/deg2和(45.54±4.33)n V/deg2;RETI系统使用BA电极时2环的N1波和P1波潜伏期分别为(20.45±3.65)nV/deg2和(42.44±3.64)nV/deg2,两种系统在2环的N1波潜伏期比较,差异有统计学意义(t=-3.16,P<0.05);P1波潜伏期比较,差异有统计学意义(t=3.52,P<0.05)。结论 VERIS系统和RETI系统均能记录患者的mfE RG,反映患眼视网膜的功能异常,在mfE RG上黄斑水肿在中心凹处改变得最明显。

Objective To investigate the differenee and correlation of VERIS and RETI in the evaluation of retinal function in two kinds of multifocal retinal （mfERG） systems. Methods From May 2012 to May 2014 in Liaoning Province, Shenyang Aier Hospital Department of Ophthalmology Department of visual function for treatment of 60 eases （60 eyes） clinical data of the subjects were retrospeetively analyzed. VERIS system using BA eleetrode,RETI system using BA or DTL electrode,36 eases （36 eyes） of normal eyes were measured mfERG, and eorrelation analysis;YERIS system and RETI system were measured in 24 cases （24 eyes） with BA electrode mfERG, and analysis. The Pearson relationship between VERIS system and RETI system to measure the normal eyes of N1 wave and P1 wave amplitude density and latency when compared;measurement of maeular edema in eyes of N1 wave and PI wave amplitude density and latency of the eorrelation between the mean standard deviation （x＋s） in the form of table shows, and the method of independent sample t test comparison. Results Normal eyes ： VERIS system and RET1 system were used in the BA electrode, the N1 wave amplitude density in 2,3,4 and 5 rings of correlation, the difference was statistically significant （ r= 0. 62 , 0 . 64 , 0. 69 , 0. 70 ; P〈0.05 ）. The correlation between N1 and RETI wave amplitude density at 2,4 and 5 rings were statistically significant （r = 0. 61,0. 59,0. 51 ;P〈0.05 ）. In the RETI system, the correlation between N1 wave amplitude and DTL wave amplitude in the 1 ring was statistically significant （r = 0. 67, P〈 0. 05 ）, respectively. VERIS system and RETI system using BA eleetrode,the P1 wave amplitude density in the correlation between the rings, the differenee was statistically signifieant （r=0.61,0.84,0.68,0.77,0.69;P〈0.05）. The correlation between VERIS and RETI wave amplitude density at 1 and 2 rings was statistieally significant （ r = 0. 64,0.58 ; P 〈 0.05 ）. In the RETI system,the correlation between Pl wave amplitude and DTL wave amplitude in the 2 ring was statistically significant （r=0.60, P〈0.05）, respectively. VERIS system and RETI system were used to compare the correlation between BA and N1 in the 2 cycle, the difference was statistically significant （r= O. 62, P〈0.05 ）. VERIS system was used for the BA electrode and the RETI system used the DTL electrode ,while the latency of N1 wave was significantly different （ r= -0.03,-0.05, -0.21, -0.08,0.32 ; P〉0.05 ）. RETI system was used in the BA and DTL eleetrodes,N1 wave latency in the ring of the correlation, the difference was not statistically significant （ r = -0.03,0.10,0.21,0.30,0.17 ; P〉O. 05 ）. VERIS system and RETI system were used in the BA electrode, P1 wave latency in 2,3 and 5 rings of eorrelafion, the difference was statistically significant （ r = 0. 53 ,0. 76,0. 65 ; P〈0. 05 ）. The correlation of P1 wave latency in the 5 ring was statistically signifieant（ r = 0.58, P〈0.05 ） , while VERIS was used for the BA electrode and the RETI electrode was used for DTL. RETI system was used to compare the correlation between BA and RETI electrodes, P1 wave latency in each ring, and the differenee was statistically significant （ r = 0.70,0.64, 0. 60,0.57,0.65 ; P〈 0.05 ）. Maeular edema： Nl and PI wave amplitude densities of the 1 rings were （27.67±2.31 ） nV/deg2 and （70.32±22.35） nV/deg2 VERIS. RETI system using the BA electrode 1 ring Nt and Pt wave amplitude density were （21.35±2.64） nV/deg2 and （62.42±18.54） nV/deg2 , the two systems in the 1 ring N~ wave amplitude density, the differenee was statistically significant （t=2.38 ,P〈0.05 ）. The amplitude of Pt wave was significantly different （t = 2.01, P〈0.05 ）. VERIS system using the BA electrode, the 2 ring of the N1 wave and PI wave amplitude density were （20.47±2. O1 ） nV/deg2 and （47.63±12.43） nV/deg2. RETI system using the BA electrode 2 ring N1 and P1 wave amplitude density were （ 18.63±2.41 ） nV/deg2 and （37.47±13.34） nV/deg2 ,the two systems in the 2 ring N1 wave amplitude density,the difference was not statistically significant （ t = -0.32, P〉0.05 ）. The amplitude of Pl wave was significantly different （ t = 3.52, P〈0.05）. The VERIS wave and PI wave latency of the 1 loop of the BA system were （21.14±4.24） nV/ deg2 and （40.35±4.55） nV/deg2. In the RETI system,the latency of N1 wave and P1 wave in the 1 loop of the BA electrode were （20.35±3.35 ） nV/deg2 and （32.22±5.74） nV/deg2, the latency of the two systems in the 1 ring of NI was not statistieally significant （ t = 0.93, P 〉 0. 05 ）. The latency of Pl wave was statistically significant （t = 3.57, P〈0.05 ）. Conclusion VERIS system and RETI system can record the patient＇s mfERG,whieh reflects the functional abnormalities of the eyes, and the most obvious changes in the mfERG.