近视患者黄斑区视网膜多焦视网膜电图和光学相干断层扫描的评估和分析

Evaluation and analysis of macular retina by multifocal electroretinogram and optical coherence tomography in myopia

目的使用多焦视网膜电图和光学相干断层扫描对近视患者黄斑区视网膜进行评估和分析。方法符合入选条件的113例113眼,根据屈光度数和眼轴长度分为四组:正视组31例(31眼),等效球镜度数为+0.75～-0.50 D,且眼轴长度为22～24 mm;低中度近视组26例(26眼),等效球镜度数为>-0.50～-6.00 D,且眼轴长度为>24～26 mm;高度近视组34例(34眼),等效球镜度数为>-6.00～-10.00 D,且眼轴长度为>26～28 mm;超高度近视组22例(22眼),等效球镜度数>-10.00 D,且眼轴长度>28 mm。使用多焦视网膜电图和光学相干断层扫描对入选患者黄斑区视网膜功能和厚度进行测量。结果随着近视程度的增加,各环P1波反应密度值逐渐减小,1环、2环、3环不同程度近视组间P1波反应密度差异均有统计学意义(均为P=0.00)。随着近视程度的增加,各环P1波振幅总和均逐渐减小,1～5环不同程度近视组间P1波振幅总和差异均有统计学意义(均为P=0.00)。随着近视程度的增加,P1波潜伏期逐渐延长,1环、2环、3环不同程度近视组间P1波潜伏期差异均有统计学意义(均为P=0.00)。随着近视程度的增加,黄斑中心凹视网膜厚度增加(P<0.001)。黄斑中心凹视网膜厚度与P1波反应密度呈负相关(r=-0.261,P=0.003),与P1波振幅总和呈负相关(r=-0.402,P<0.001),与P1波潜伏期呈正相关(r=0.340,P<0.001)。结论随着近视程度的增加,黄斑中心凹视网膜厚度增加,视网膜功能下降。

Objective To investigate the changes of macular retinal function and structure in myopic subjects using multifocal electroretinography (mfERG) and optical coherence tomography (OCT). Methods One hundred and thirteen subjects (113 eyes) with age ranging from 18 to 35 years old were enrolled in the study.The subjects were divided into four groups according to spherical equivalent (SE) and axial length (AL):emmetropia (E) group ( n =31;SE:+0.75 to -0.50 D;AL:22 to 24 mm),low and medium myopia (LMM) group ( n =26;SE:>-0.50 to -6.00 D;AL:>24 to 26 mm),high myopia (HM) group ( n =34;SE:>-6.00 to -10.00 D;AL:>26 to 28 mm) and super high myopia (SHM) group ( n =22;SE:>-10.00 D;AL:=28 mm).The changes of macular retinal function and the central subfield macular thickness (CST) were obtained using mfERG and OCT. Results As the degree of myopia increased,the average response density values of the P1 waves of each ring gradually decreased.The differences of the mean response density values of P1 waves of 1-3 ring among different groups were significantly different (all P <0.01).As the degree of myopia increased,the amplitudes of the P1 waves of each ring gradually decreased.The differences of the amplitudes of P1 waves of 1-5 ring among different groups were significantly different (all P <0.01).As the degree of myopia increased,the latency of the P1 wave was gradually increased.The differences of the latencies of P1 waves of 1-3 ring among different groups were significantly different (all P <0.01).As the degree of myopia increased,the CST increased ( P <0.001).The CST was negatively correlated with the average response density and the sum amplitude of the P1 wave of 1 ring ( r =-0.261 ,-0.402;P =0.003, P <0.001),and positively correlated with the P1 wave latency ( r =0.340, P <0.001). Conclusion As the degree of myopia increases,the CST increases and the function of the retina declines.