视网膜色素变性患者手术治疗45名(英文)

Surgical therapy in 45 patients with retinitis pigmentosa

目的:评估视网膜色素变性患者的手术疗效。方法:对45名视网膜色素变性患者90眼进行手术治疗,术前和术后分别对这些患者进行了视锐度、自动视野计和三种视觉电生理指标(F-ERG、EOG和P-VEP)的检测。结果:术后3～22月,患者的视锐度得到了明显的改善,视野显著扩大,视野缺损减低。术前在90眼中有73眼(81.1%)的暗视F-ERG为熄灭型,在术后3～22月期间进行复查时,有些曾消失的F-ERG波复现,暗视F-ERG为熄灭型的眼下降至66(73.3%)只(P <0.05, t检验),一些原来残存的F-ERG波的波幅增加,峰潜伏期也缩短。EOG曲线变得更为弯曲,某些EOG的参数(如Arden比和G比值)也明显的增加(P <0.05, t检验)。用棋盘格翻转刺激中央6о视野时能够记录到P-VEP的患者数目,在45例中由术前的22例在术后增加到31例。这45例的残存P100波的平均振幅由术前的1.007μV增加到术后的2.236μV,有显著的统计学差异(P<0.005, t检验)。结论:手术治疗RP是有效和安全的,并能改善患者的视觉和阻止RP病程的发展。

AIM: To assess the therapeutic effect of surgery for patients with retinitis pigmentosa (RP).· METHODS: Ninety eyes of 45 RP patients were treated with surgery. Visual acuity, automated perimetry and three electrophysiological measures (F-ERG, EOG and P-VEP) were examined pre- and postoperatively.· RESULTS: Three to twenty-two months after the surgical therapy, the best-corrected visual acuity improved significantly, the visual field extended clearly, and the mean defect of visual field decreased obviously. Out of the 90 eyes, the scotopic F-ERG of 73(81.1%) eyes was non-detectable preoperatively and the number of such eyes decreased to 66(73.3%) postoperatively (P < 0.05,t -test). During a 3-22-month follow-up (mean= 10.9±5.1 months, n =45), some waves of F-ERP in RP patients reappeared. The amplitudes of residual waves of F-ERG increased and their implicit time shortened, however, with no statistically significant differences (P >0.05, t -test). The EOG traces became more curved and some (8 eyes) of the smooth traces had changed to curved ones. Some of the EOG parameters such as Arden ratio and Gliem (G) ratio increased significantly (P ≤0.05, t -test), too. The number of patients from whom the P-VEP could be recorded when the 6°center of visual fields was stimulated increased greatly from 22 to 31 out of the total 45 patients. The mean amplitude of residual P100 in 45 RP patient was also significantly increased from 1.007 to 2.236μV (P <0.005, t -test). · CONCLUSION: The surgical treatment is effective and safe, and it can improve vision and halt RP progression.·