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目的探讨视网膜静脉阻塞(retinal vein occlusion,RVO)继发黄斑水肿(macula edema,ME)患者多焦视网膜电图(multifocal electroretinogram,mf-ERG)和光学相干断层扫描(optical coherence tomography,OCT)的特征。方法对38例(38眼)确诊为RVO继发ME患者进行mf-ERG及OCT检查,选取同期门诊中正常人23例(23眼)作为正常对照组。OCT用于测量直径1.0 mm黄斑中心圆形区的黄斑视网膜厚度(macular retinal thickness,)CMT,mf-ERG评价黄斑部视网膜功能,并分析环1~环5中P1波振幅密度及P1、N1波潜伏期变化。结果与正常对照组比较,BRVO组:P1波振幅密度在环2(35.95±17.04)nV·deg-2,环3(24.72±8.32)nV·deg-2,环4(19.28±6.38)nV·deg-2,环5(13.49±6.16)nV·deg-2显著下降(均为P<0.05);P1波潜伏期在环2(35.74±3.72)ms有明显延迟(P<0.05);N1波潜伏期在环2(18.43±4.63)ms、环3(18.67±2.86)ms有明显延迟(均为P<0.05)。与正常对照组比较,CRVO组:P1波振幅密度在环1(81.58±43.15)nV·deg-2、环2(33.71±9.81)nV·deg-2、环3(22.15±9.75)nV·deg-2、环4(16.65±6.38)nV·deg-2、环5(14.18±4.59)nV·deg-2显著下降(均为P<0.05);P1波潜伏期在环2(37.56±5.55)ms、环3(37.31±5.22)ms、环4(35.71±5.63)ms、环5(37.30±5.37)ms有明显延迟(均为P<0.05);N1波潜伏期在环1(21.82±5.76)ms、环2(19.18±4.82)ms、环3(19.31±4.25)ms、环4(19.05±4.55)ms、环5(19.43±4.12)ms有明显延迟(均为P<0.05)。CRVO组CMT与mf-ERG环1中P1振幅密度呈负相关(r=-0.576,P<0.05)。结论 OCT与mfERG相结合能更好地反映RVO继发ME患者的黄斑部视网膜形态与功能变化。
Objective To investigate the characteristics of mf-ERG and optical coherence tomography (OCT) in patients with retinal vein occlusion (RVO) . Methods mf-ERG and OCT were performed in 38 patients (38 eyes) diagnosed as RVO secondary to ME. 23 normal subjects (23 eyes) were selected as normal control group. OCT was used to measure macular retinal thickness (CMT) and mf-ERG in macular central circle with a diameter of 1.0 mm to evaluate macular retinal function. The amplitude of P1 wave amplitude and P1, N1 wave in ring 1 ~ ring 5 Latency changes. Results Compared with the normal control group, the amplitudes of P1 wave in BRVO group were significantly higher than those in control group (P <0.05). The amplitude of P1 wave amplitude in ring 2 (35.95 ± 17.04) nV deg-2, ring 3 (24.72 ± 8.32) nV deg-2, ring 4 (19.28 ± 6.38) (P <0.05). The latency of P1 wave was significantly delayed in ring 2 (35.74 ± 3.72) ms (P <0.05), the latency of N1 wave was significantly lower than that in ring 2 (13.49 ± 6.16) nV · deg- At ring 2 (18.43 ± 4.63) ms, ring 3 (18.67 ± 2.86) ms was significantly delayed (all P <0.05). Compared with the normal control group, the amplitude of P1 wave amplitude in ring 1 (81.58 ± 43.15) nV deg-2, ring 2 (33.71 ± 9.81) nV deg-2, ring 3 (22.15 ± 9.75) nV deg (P <0.05). The latency of P1 wave in ring 2 (37.56 ± 5.55) ms was significantly lower than that in ring 2 (16.65 ± 6.38) nV · deg-2 and ring 5 (14.18 ± 4.59) , Ring 3 (37.31 ± 5.22) ms, ring 4 (35.71 ± 5.63) ms and ring 5 (37.30 ± 5.37) ms were significantly delayed (all P <0.05) , Ring 2 (19.18 ± 4.82) ms, ring 3 (19.31 ± 4.25) ms, ring 4 (19.05 ± 4.55) ms and ring 5 (19.43 ± 4.12) ms respectively (all P <0.05). The CMV of CRVO group was negatively correlated with P1 amplitude density in ring 1 of mf-ERG (r = -0.576, P <0.05). Conclusion The combination of OCT and mfERG can better reflect the changes of macular retinal morphology and function in patients with secondary MEO.