| [摘要] 目的 应用多焦视网膜电图(mfERG) 一阶Kernel反应（FOK），观察其在早期原发性开角型青光眼患者中的变化 , 评价其在青光眼中的诊断价值。方法 根据1987 年全国青光眼协作组拟定的标准，采用多焦视觉电生理检查系统(RETIscan 3. 11version)和Humphrey 750-i 视野计，检测了正常眼19例（19只眼）和早期原发性开角型青光眼13例（13只眼）。记录了多焦视网膜电图 一阶Kernel反应的P1波在1-5环和四个象限的振幅密度和潜时。先将原始数据输入EXCEL 软件,再转入SPSS 10. 0 软件进行统计学处理。结果 早期青光眼组的P1 波1-5环振幅密度较正常对照组均明显下降( P < 0.05)，P1 波潜时明显延长，与正常对照组对比差异有显著性( P < 0.05)。早期青光眼组鼻上(SN ) 象限 P1波的振幅密度明显下降，与正常对照组有显著性差异( P＜0.05)，而在其它象限无显著性差异（P＞0.05）。鼻上(SN )、鼻下(IN),颞下(IT),颞上(ST)4 个象限潜时延长，与正常对照组有显著性差异( P＜0.05)。结论 mfERG 是一种检测青光眼的敏感方法，可以为早期青光眼的诊断提供有效的依据。但尚未发现具有典型特征性的mfERG改变。在临床上应该是多种指标联合检测,以提高诊断的敏感性、准确性。
[关键词] 原发性开角型青光眼；多焦视网膜电图；早期诊断
Evaluation of mfERG in the Diagnosis of Early Primary Open Angle Glaucoma
FAN Rui ZHAO Ping Shenyang Aier Eye Hospital,110003
YANG Qi-chang The Fourth Hospital of China Medical Univercity,110003
[Abstract] Objective We evaluated the changes of first order Kernel (FOK) reaction of mfERG in early primary open angle glaucoma (POAG). Methods Early POAG is diagnosed according to the standards proposed by National Glaucoma Collaborative Group in 1987. Nineteen normal eyes and 13 POAG eyes were examined with mfERG (RETIscan 3.11 version) and Humphrey 750-I perimetry. Amplitude density and latent time of FOK P1 in five rings and four quadrants were recorded and analyzed by SPSS ver 10.0. Results Amplitude density of P1 of five rings of early POAG were significantly decreased compared with normal eyes (P<0.05). Latent time of P1 were also prolonged (P<0.05). Amplitude density of P1 in supranasal quadrant (SN) was significantly decreased (P<0.05), but not significantly changed in other quadrants (P>0.05). The latent time of four quadrants (SN, IN, IT, ST) were prolonged significantly (P<0.05). Conclusions MfERG is a sensitive method to detect glaucoma and can provide effective evidence for the early diagnosis. But no characterized changes are detected. We should combine multiple examinations to get sensitive and accurate diagnosis.
Key Words Primary Open Angle Glaucoma；Multi-focal Electroretinography ；Early Diagnosis
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