眼表碱烧伤患者视网膜电图临床观察

Clinical observation of electroretinogram examination in ocular alkali burn

目的研究眼表碱烧伤患者视网膜电图(ERG)波形的振幅变化,并探讨功能学检查ERG在碱烧伤中的临床意义。方法选取2018年5月至2019年10月在北京大学第三医院眼科就诊的碱烧伤患者13例,男12例,女1例,年龄19~60岁,总计伤眼15眼作为碱烧伤组;选择机械性单眼外伤患者的对侧眼15眼作为正常对照组。两组行ERG检查,观察并分析比较碱烧伤组和正常对照组各项反应波幅的变化。结果相对于正常对照组,碱烧伤组暗适应0.01ERG b波振幅[(137±23)μV比(348±14)μV,P<0.001],暗适应3.0ERG和暗适应10.0ERG a波振幅[(172±20)μV比(335±17)μV;(220±21)μV比(368±19)μV,均P<0.001],暗适应3.0ERG和暗适应10.0ERG b波振幅[(359±21)μV比(610±20)μV;(384±21)μV比(612±19)μV,均P<0.001],暗适应3.0ERG振荡电位(OPs)振幅[(94±13)μV比(209±8)μV,P<0.001]均降低。相对于正常对照组,碱烧伤组明适应3.0ERG a波振幅[(40±4)μV比(58±3)μV,P<0.001],明适应3.0ERG b波振幅[(90±11)μV比(146±6)μV,P<0.001],明适应3.0闪烁光反应[(93±11)μV比(166±10)μV,P<0.001]均降低。结论碱烧伤除了造成眼表形态学改变,同时也引起眼视功能学的改变。

Objective To investigate the wave variations of the electroretinography(ERG),and explore the clinical value of using ERG in alkali injury.Methods A total of 13 patients with alkali burns who were treated in the Department of Ophthalmology of Peking University Third Hospital from May 2018 to October 2019 were selected,including 12 males and 1 female.The age ranged from 19 to 60 years old.A total of 15 injured eyes were used as the alkali burn group,meanwhile,another 15 contralateral eyes with mechanical unilateral trauma were used as the healthy controls.ERG examination was performed to compare the amplitudes of 6 activation-induced responses between the two groups.Results Compared with control group,b-wave amplitude of dark adaption 0.01 ERG in alkali injury group decreased[(137±23)μV vs(348±14)μV,P<0.001].Compared with control group[(335±17)μV and(368±19)μV],a-wave amplitude of dark adaption 3.0 ERG and 10.0 ERG in alkali injury groups[(172±20)μV and(220±21)μV]were decreased(both P<0.001).As for b-wave amplitude of dark adaption 3.0 ERG and 10.0 ERG,compared with control group[(610±20)μV and(612±19)μV],those of alkali injury groups[(359±21)μV and(384±21)μV]were decreased(both P<0.001).In terms of oscillatory potentials(OPs)amplitude of dark 3.0 ERG adaption,compared with control group[(209±8)μV],that of alkali injury group[(94±13)μV]was decreased(P<0.001).Compared with normal group[(58±3)μV],a-wave amplitude of light adaption 3.0 ERG in alkali injury group[(40±4)μV]was decreased(P<0.001).As for b-wave amplitude of light adaption 3.0 ERG,compared with control group[(146±6)μV],that of alkali injury group[(90±11)μV]was decreased(P<0.001).In terms of photopic 3.0 flicker 30 Hz of light adaption,compared with control group[(166±10)μV],that of alkali injury group[(93±11)μV]was decreased(P<0.001).Conclusion Alkali injury can cause ocular surface morphological changes,meanwhile,it leads to the alternations of the visual function.