CAJ | 학술논문

目的观察分析非动脉炎性前部缺血性视神经病变(NAION)的多焦视网膜电图(mfERG)特征及其与视力、黄斑中心区视网膜厚度(CRT)的关系.方法临床病例自身对照研究.经最佳矫正视力、眼底彩色照相、荧光素眼底血管造影及视野检查确诊为NAION的40例患者40只眼纳入研究.所有患眼及其对侧健康眼行傅立叶域光相干断层扫描(FD-OCT)及mfERG检查.FD-OCT测量受检眼黄斑中心凹周围区、黄斑旁中心凹区视网膜厚度及CRT.mfERG检测受检眼黄斑部视网膜功能.以黄斑中心凹为中心,将反应区由内向外呈同心圆划分为5个环区,分别为1环0.00°、2环5.44°、3环10.31°、4环16.31°、5环23.42°.以1环中心六边形为黄斑中心区.观察分析各环P1波、N1波振幅、潜伏时及P1波振幅密度.采用Spearman相关性分析法分析黄斑中心区P1波、N1波振幅及P1波振幅密度与视力、CRT的相关性.结果与对侧健康眼比较,患眼黄斑中心凹周围区视网膜厚度明显增厚,差异有统计学意义(P＜0.05);黄斑旁中心凹区视网膜厚度及CRT略有增厚,但差异无统计学意义(P＞0.05).与对侧健康眼比较,患眼1、2环P1波振幅密度明显降低,差异有统计学意义(P＜0.05);3～5环P1波振幅密度无明显变化,差异无统计学意义(P＞0.05).患眼1环P1波、N1波振幅均明显降低,差异有统计学意义(P＜0.05);2～5环P1波、N1波振幅及1～5环P1波、N1波潜伏时均无明显变化,差异无统计学意义(P＞0.05).相关性分析结果显示,患跟黄斑中心区P1波振幅密度、振幅及N1波振幅与视力(r=-0.087、0.195、-0.134)、CRT(r=-0.154、0.365、0.412)均无明显相关性(P＞0.05).结论 NAION患眼1、2环P1波振幅密度及1环P1波、N1波振幅较对侧健康眼明显降低.患眼黄斑中心区P1波振幅密度、振幅及N1波振幅与视力、CRT均无明显相关性.
목적 관찰분석비동맥염성전부결혈성시신경병변(NAION)적다초시망막전도(mfERG)특정급기여시력、황반중심구시망막후도(CRT)적관계.방법 림상병례자신대조연구.경최가교정시력、안저채색조상、형광소안저혈관조영급시야검사학진위NAION적40례환자40지안납입연구.소유환안급기대측건강안행부립협역광상간단층소묘(FD-OCT)급mfERG검사.FD-OCT측량수검안황반중심요주위구、황반방중심요구시망막후도급CRT.mfERG검측수검안황반부시망막공능.이황반중심요위중심,장반응구유내향외정동심원화분위5개배구,분별위1배0.00°、2배5.44°、3배10.31°、4배16.31°、5배23.42°.이1배중심륙변형위황반중심구.관찰분석각배P1파、N1파진폭、잠복시급P1파진폭밀도.채용Spearman상관성분석법분석황반중심구P1파、N1파진폭급P1파진폭밀도여시력、CRT적상관성.결과 여대측건강안비교,환안황반중심요주위구시망막후도명현증후,차이유통계학의의(P＜0.05);황반방중심요구시망막후도급CRT략유증후,단차이무통계학의의(P＞0.05).여대측건강안비교,환안1、2배P1파진폭밀도명현강저,차이유통계학의의(P＜0.05);3～5배P1파진폭밀도무명현변화,차이무통계학의의(P＞0.05).환안1배P1파、N1파진폭균명현강저,차이유통계학의의(P＜0.05);2～5배P1파、N1파진폭급1～5배P1파、N1파잠복시균무명현변화,차이무통계학의의(P＞0.05).상관성분석결과현시,환근황반중심구P1파진폭밀도、진폭급N1파진폭여시력(r=-0.087、0.195、-0.134)、CRT(r=-0.154、0.365、0.412)균무명현상관성(P＞0.05).결론 NAION환안1、2배P1파진폭밀도급1배P1파、N1파진폭교대측건강안명현강저.환안황반중심구P1파진폭밀도、진폭급N1파진폭여시력、CRT균무명현상관성.
Objective To observe the characteristics of multifocal eletrotetinogram (mfERG) in nonarteritic anterior ischemic optic neuropathy (NAION) and its relationship with visual acuity and macular central retinal thickness (CRT).Methods By means of patients self-contrast analysis.40 patients (40 eyes) with NAION were collected underwent the examinations of best corrected visual acuity, fundus color photography, fundus fluorescein angiography and field of vision.All the disease and normal eyes had underwent the examination of frequency-domain optical coherence tomography (fdOCT) and mfERG.The CRT and retinal thickness about perifovea, parafovea were documented with fdOCT.All patients underwent the retinal macular function exam with mfERG.Centered by macular fovea, the reaction zone were divided into 5 rings from inside to outside by circles, ring 1 0.00°, ring 2 5.44°, ring 3 10.31°, ring 4 16.31°, ring 5 23.42°.Treated ring 1 hexagon as macular center the amplitude densities of P1 wave, the amplitude of P1 and N1 wave, and the latencies of P1and N1 wave at cvcry ring were observed.The relationship between mfERG characteristics and visual acuity or CRT were analyzed by Spearman correlation analysis.Results fdOCT revealed that there was significantly statistical difference in the retinal thickness about perifovea between disease eyes and contralateral eyes (P＜＜0.05).The increase of CRT and retinal thickness about parafovea had no significantly statistical difference between diseases eyes and contralateral eyes (P＞0.05).mfERG revealed that the decrease of amplitude densities about P1 wave at ring 1 to 2 had significantly statistical difference between two groups (P＜0.05);there were no significantly statistical difference in the amplitude densities of P1 wave at ring 3 to 5;the decrease of amplitude about P1 and N1 wave at ring 1 had significantly statistical difference between two groups (P ＜ 0.05).There was no significantly statistical difference in the amplitude of P1 and N1wave at ring 2 to 5, the latencies of P1 and N1 wave at ring 1 to 5 (P＞0.05).The correlation analysis revealed that the amplitude densities and amplitude of P1 wave at ring 1, amplitude of N1 wave at ring 1 had no effect on visual acuity (r=0.087,0.195,-0.134;P＞0.05) and CRT(r=-0.154,0.365, 0.412;P＞0.05).Conclusions Compared with contralateral eyes,the disease eyes were significantly decrease in amplitude densities of P1 wave at ring 1 to 2, amplitude of P1 and N1 wave at ring 1.There are no correlated between the amplitude densities of P1 wave at ring 1,amplitude of P1 and N1 wave at ring 1 and visual acuity or CRT.