中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2014年
3期
274-277
,共4页
视网膜营养不良%视网膜电描记术%色觉缺陷
視網膜營養不良%視網膜電描記術%色覺缺陷
시망막영양불량%시망막전묘기술%색각결함
Retinal dystrophies%Electroretinography%Color vision defects
目的 观察迟发性视锥细胞营养不良(LOCD)患者的临床特征.方法 临床检查确诊的LOCD患者11例15只眼纳入研究.其中,男性7例,女性4例.年龄50～79岁,平均年龄60.2岁.患者畏光和昼盲症状不明显.视力≤0.05者4只眼;0.06～0.2者5只眼;0.3～1.0者6只眼.所有患者行视力、裂隙灯显微镜、间接检眼镜、闪光视网膜电图(F-ERG)、多焦视网膜电图(mfERG)检查.行荧光素眼底血管造影(FFA)检查11只眼、光相干断层扫描(OCT)检查13只眼,色觉检查6只眼.结果 行色觉检查的6只眼中,红绿色盲4只眼;色弱2只眼.15只眼中,眼底检查正常11只眼;黄斑色素紊乱4只眼.行FFA检查的11只眼中,正常5只眼;黄斑色素紊乱表现为荧光遮蔽及透见荧光点相间4只眼;黄斑卵圆形萎缩灶2只眼.F-ERG检查结果显示,明视b波振幅下降6只眼.其中,轻度4只眼;中重度各1只眼.明视、暗视b波振幅下降9只眼.mfERG检查结果显示,距中心凹7°范围内的视锥细胞中心异常5只眼;中心、距中心凹7°范围以外的周边部分均异常10只眼.OCT检查结果显示,黄斑色素上皮改变3只眼.黄斑中心凹视网膜厚度正常8只眼;黄斑薄变5只眼.黄斑薄变的5只眼,黄斑厚度83～111μm.结论 LOCD患者早期眼底黄斑区正常,晚期呈卵圆形萎缩.可有色觉异常.F-ERG检查表现为早期明视b波振幅下降或晚期明视、暗视b波振幅均下降.mfERG检查表现为视锥细胞中心和(或)周边部异常.
目的 觀察遲髮性視錐細胞營養不良(LOCD)患者的臨床特徵.方法 臨床檢查確診的LOCD患者11例15隻眼納入研究.其中,男性7例,女性4例.年齡50～79歲,平均年齡60.2歲.患者畏光和晝盲癥狀不明顯.視力≤0.05者4隻眼;0.06～0.2者5隻眼;0.3～1.0者6隻眼.所有患者行視力、裂隙燈顯微鏡、間接檢眼鏡、閃光視網膜電圖(F-ERG)、多焦視網膜電圖(mfERG)檢查.行熒光素眼底血管造影(FFA)檢查11隻眼、光相榦斷層掃描(OCT)檢查13隻眼,色覺檢查6隻眼.結果 行色覺檢查的6隻眼中,紅綠色盲4隻眼;色弱2隻眼.15隻眼中,眼底檢查正常11隻眼;黃斑色素紊亂4隻眼.行FFA檢查的11隻眼中,正常5隻眼;黃斑色素紊亂錶現為熒光遮蔽及透見熒光點相間4隻眼;黃斑卵圓形萎縮竈2隻眼.F-ERG檢查結果顯示,明視b波振幅下降6隻眼.其中,輕度4隻眼;中重度各1隻眼.明視、暗視b波振幅下降9隻眼.mfERG檢查結果顯示,距中心凹7°範圍內的視錐細胞中心異常5隻眼;中心、距中心凹7°範圍以外的週邊部分均異常10隻眼.OCT檢查結果顯示,黃斑色素上皮改變3隻眼.黃斑中心凹視網膜厚度正常8隻眼;黃斑薄變5隻眼.黃斑薄變的5隻眼,黃斑厚度83～111μm.結論 LOCD患者早期眼底黃斑區正常,晚期呈卵圓形萎縮.可有色覺異常.F-ERG檢查錶現為早期明視b波振幅下降或晚期明視、暗視b波振幅均下降.mfERG檢查錶現為視錐細胞中心和(或)週邊部異常.
목적 관찰지발성시추세포영양불량(LOCD)환자적림상특정.방법 림상검사학진적LOCD환자11례15지안납입연구.기중,남성7례,녀성4례.년령50～79세,평균년령60.2세.환자외광화주맹증상불명현.시력≤0.05자4지안;0.06～0.2자5지안;0.3～1.0자6지안.소유환자행시력、렬극등현미경、간접검안경、섬광시망막전도(F-ERG)、다초시망막전도(mfERG)검사.행형광소안저혈관조영(FFA)검사11지안、광상간단층소묘(OCT)검사13지안,색각검사6지안.결과 행색각검사적6지안중,홍록색맹4지안;색약2지안.15지안중,안저검사정상11지안;황반색소문란4지안.행FFA검사적11지안중,정상5지안;황반색소문란표현위형광차폐급투견형광점상간4지안;황반란원형위축조2지안.F-ERG검사결과현시,명시b파진폭하강6지안.기중,경도4지안;중중도각1지안.명시、암시b파진폭하강9지안.mfERG검사결과현시,거중심요7°범위내적시추세포중심이상5지안;중심、거중심요7°범위이외적주변부분균이상10지안.OCT검사결과현시,황반색소상피개변3지안.황반중심요시망막후도정상8지안;황반박변5지안.황반박변적5지안,황반후도83～111μm.결론 LOCD환자조기안저황반구정상,만기정란원형위축.가유색각이상.F-ERG검사표현위조기명시b파진폭하강혹만기명시、암시b파진폭균하강.mfERG검사표현위시추세포중심화(혹)주변부이상.
Objective To observe the clinical features of late-onset cone dystrophy (LOCD).Methods Eleven patients (15 eyes) of LOCD were enrolled in this study.The patients included 7 males and 4 females.The age was ranged from 50 to 79 years,with a mean age of 60.2 years.There was no obvious photophobia and hemeralopia.The visual acuity was less than or equal to 0.05 in 4 eyes,0.06-0.2 in 5 eyes,0.3-1.0 in 6 eyes.Visual acuity,slit lamp microscope,indirect ophthalmoscopy,flash electroretinogram (FERG) and multifocal electroretinograms (mfERG) were examined for all patients,fundus fluorescein angiography (FFA) for 11 eyes,optical coherence tomography (OCT) and chromoptometry for 6 eyes.Results There were 6 eyes with red/green color blindness,2 eyes with color weakness.Normal fundus was found in 11 eyes,while derangement of macular pigment epithelial in 4 eyes.FFA results showed that there were 5 eyes with normal fundus,4 eyes with blocked fluorescent spots,2 eyes with oval macular atrophy.FERG results showed that in cone response,the amplitude was lower in 6 eyes (including mild decrease in 4 eyes,moderate decrease in 1 eye and severe decrease in 1 eye) ; both in cone and rod response,the amplitude were lower in 9 eyes.mfERG results showed that central part of the cone (less than 7 degree from the center) was damaged in 5 eyes,both central and peripheral part (outside of 7 degree) of the cone were damaged in 10 eyes.OCT results showed that pigment derangement in 3 eyes,fovea was normal in 8 eyes,thinned in 5 eyes (foveal thickness was 83-111 μm).Conclusions The fundus manifestations of LOCD patients are variable,from normal fundus to oval macular atrophy.FERG is abnormal,which mainly in cone response at early stage and both in cone and rod response at late stage.Central part and (or) peripheral part of the cone are abnormal by mfERG.
