CAJ | 학술논문

目的观察Behcet病后葡萄膜炎对后极部视网膜功能的影响.方法对39例(68眼)活动期Behcet病患者进行多焦视网膜电图(mfERG)检测.受试眼根据荧光素眼底血管造影(FFA)表现分为Behcet病合并囊样黄斑水肿(CME)组和Behcet病合并弥漫黄斑水肿(DME)组,分析其mfERG特点.17名年龄和性别匹配的正常受试者作为正常对照组.mfERG的检测遵循国际临床视觉电生理学会标准化的要求.结果与正常对照组相比,Behcet病患者mfERG1～6环P1波振幅明显降低,差异均有统计学意义(P＜0.01);1～5环N_1波振幅明显降低,差异均有统计学意义(P＜0.01);Behcet病患者1～6环P_1波隐含时缩短,但差异无统计学意义(P＞0.05).Behcet病合并DME组mfERG1～6环P1波、N1波振幅较Behcet病合并CME组均明显降低(P＜0.05,P＜0.01).Behcet病合并CME组患者视力与1环的N_1波隐含时及振幅均呈负相关(r=-0.36,r=-0.37,P＜0.05),与1环的P1波振幅呈正相关(r=0.43,P＜0.05).Behcet病合并DME组患者的视力与1环的N1波振幅、隐含时及P_1波振幅均呈负相关(r=-0.41,r=-0.35,r=-0.40;P＜0.05),与1环P_1波振幅呈正相关(r=0.48,P＜0.05).结论黄斑中心凹是Behcet病患者视网膜功能降低最严重的部位.Behcet病患者mfERG的异常主要表现为视网膜电位的幅度改变,对视网膜电活动的时程无明显延迟作用.
목적 관찰Behcet병후포도막염대후겁부시망막공능적영향.방법 대39례(68안)활동기Behcet병환자진행다초시망막전도(mfERG)검측.수시안근거형광소안저혈관조영(FFA)표현분위Behcet병합병낭양황반수종(CME)조화Behcet병합병미만황반수종(DME)조,분석기mfERG특점.17명년령화성별필배적정상수시자작위정상대조조.mfERG적검측준순국제림상시각전생이학회표준화적요구.결과 여정상대조조상비,Behcet병환자mfERG1～6배P1파진폭명현강저,차이균유통계학의의(P＜0.01);1～5배N_1파진폭명현강저,차이균유통계학의의(P＜0.01);Behcet병환자1～6배P_1파은함시축단,단차이무통계학의의(P＞0.05).Behcet병합병DME조mfERG1～6배P1파、N1파진폭교Behcet병합병CME조균명현강저(P＜0.05,P＜0.01).Behcet병합병CME조환자시력여1배적N_1파은함시급진폭균정부상관(r=-0.36,r=-0.37,P＜0.05),여1배적P1파진폭정정상관(r=0.43,P＜0.05).Behcet병합병DME조환자적시력여1배적N1파진폭、은함시급P_1파진폭균정부상관(r=-0.41,r=-0.35,r=-0.40;P＜0.05),여1배P_1파진폭정정상관(r=0.48,P＜0.05).결론 황반중심요시Behcet병환자시망막공능강저최엄중적부위.Behcet병환자mfERG적이상주요표현위시망막전위적폭도개변,대시망막전활동적시정무명현연지작용.
Background Behcet's disease is a refractory panuveitis with high blindness rate.Multifocal electroretinography (mfERG) is a useful tool for the evaluation of the function of the posterior retina.ObjectiveThe aim of this study is to assess the characteristics of Behcet's disease using the mfERG.Methods mfERG was recorded in 68 eyes of 39 cases with active stage of Behcet's disease.All of the patients were diagnosed based on the Standard of International Study Group for Behcet's Disease and assigned to the cystoid macular edema (CME) group and the diffuse macular edema (DME) group after assessment by fundus fluorescein angiography (FFA).Seventeen normal subjects were used as controls.Oral informed consent was obtained from all of the subjects prior to this trial.mfERG recording followed the ISCEV Guidelines for Clinical Multifocal Electroretinography (2007 edition).The response density and latency of P1 and N1 waves in 6 rings were analyzed and compared.Results The amplitudes of N_1 waves from rings 1 through 6 and N1 wave from rings 1 through 5 were significantly declined in patients with Behcet's disease compared with normal control (P＜0.01).All of the latencies of P_1 waves from rings 1 through 6 were insignificantly shortened in patients with Behcet's disease compared with normal control (P＞0.05).The amplitudes of P_1 and N_1 waves from rings 1 through 6 in diffuse macular edema group were considerably lower than those in the cystoid macular edema group (P＜0.05,P＜0.01).A test of visual acuity showed a negative correlation to the amplitude and latency of N_1 wave (r=-0.36,-0.37,P＜0.05 ) and a positive correlation with the amplitude of N1 wave (r=0.43,P＜0.05) in the DME group.In the CME group,a test of visual acuity presented a negative correlation to the amplitude and latency of N1 wave and latency of P1 (r=-0.41,-0.35,-0.40,P＜0.05 ) and a positive correlation with the amplitude of P1 wave (r=0.48,P＜0.05).Conclusion mfEGR demonstrates that retinal electro-activity is abnormal in eyes with Behcet's disease.The distinct functional disorder is situated around the fovea.