利用多焦视网膜电图检测开角型青光眼患者的黄斑功能

摘要

Objective To evaluate central retina function in patients with primary open-angle glaucoma ( POAG) using multifocal electroretinography ( mfERG) .Methods mfERGs were assessed in 36 OAG patients and 36 normal sub-jects.Ring analysis was performed at five retinal eccentricity rings from fovea to midperiphery:0°~2.5°(R1), 2.5°~5° (R2), 5°~10°(R3), 10°~15°(R4), and 15°~20°(R5).Response amplitude density of N1-P1 components (N1-P1 RAD, nV/deg2 ) and P1 latency ( P1 IT, ms) of the first-order binary kernel were measured for each ring.To calculate N1-P1 average amplitude density, visual field with mean deviation ( MD) were measured.All data were processed with lin-ear correlation analysis.Result POAG patients showed a significant decrease in N1-P1 RADs and an increase in P1 IT in both R1 and R2 with respect to controls.The reduction in N1-P1 RADs was significantly correlated with MD.Conclusions Since the mfERG N1-P1component is thought to be generated by outer retinal layers, macular dysfunction in POAG pa-tients can be detectable by the mfERG and indicates glaucoma progression.%目的：采用多焦视网膜电图（mfERG）方式检测原发性开角型青光眼（POAG）患者的黄斑区外层视网膜功能。方法对36例POAG患者和36例正常人进行mfERG检查，记录以黄班中央凹为中心5个环状视网膜区域R1（0°～2．5°）、R2（2．5°～5°）、R3（5°～10°）、R4（10°～15°）、R5（15°～20°）一阶反应 N1、P1波反应密度（单位面积的反应幅度即振幅密度值）及P1潜伏时，将一阶反应N1、P1反应密度取算术平均值产生N1-P1平均反应密度，测量POAG患者平均视野缺损值（ MD），所得数据做线性相关分析。结果与正常对照组相比，黄斑区R1、R2环内POAG患者N1、P1平均反应密度明显减少，P1潜伏时明显延长。 R1、R2环N1、P1平均反应密度减少与平均视野缺损有显著相关性。结论由于N1、P1主要起源于外层视网膜，因此mfERG能很好的显示POAG患者黄班区外层视网膜功能损害，并与青光眼病程进展相关，为青光眼临床诊断治疗提供参考。