Terasaki H, Miyake Y, Nomura R, Horiguchi M, Suzuki S, Kondo M
Department of Ophthalmology, Nagoya University School of Medicine, Japan.
Invest Ophthalmol Vis Sci. 1999 Oct;40(11):2761-4.
To resolve the discrepancy between nonrecordable full-field short wavelength cone electroretinograms (S-cone ERGs) and the presence of normal color vision in patients with the complete type of congenital stationary night blindness (CSNB1).
Conventional white-on-white (W-W) perimetry, blue-on-yellow (B-Y) perimetry, and the Farnsworth-Munsell 100-hue test were performed in five patients with CSNB1. Diagnosis of CSNB1 was made by clinical and electrophysiological examinations. Twelve normal, age-matched control subjects and an additional 7 normal, highly myopic subjects were tested.
Color vision was normal in all the CSNB1 patients by the Farnsworth-Munsell 100-hue test. B-Y perimetry demonstrated that blue cone sensitivity in CSNB1 was normal in the fixation area, but the mean sensitivities of the entire 60 degrees field, the central 0 degrees-to-15 degrees, and 15 degrees-to-30 degrees ring were significantly decreased compared with the normal and myopic subjects. The sensitivity difference between 15 degrees-to-30 degrees and 0 degrees-to-15 degrees in B-Y perimetry increased significantly in CSNB1 compared with both normal and myopic control subjects.
Our perimetric results demonstrated that the S-cone function in CSNB1 is preserved only in the fovea and becomes abnormal toward the peripheral retina. This accounts for the normal color vision that tests mainly foveal function and the nonrecordable S-cone ERGs that arise mainly from peripheral retina.
解决先天性静止性夜盲完全型(CSNB1)患者中不可记录的全视野短波长视锥细胞视网膜电图(S-视锥细胞ERG)与正常色觉存在之间的差异。
对5例CSNB1患者进行了传统的白对白(W-W)视野检查、蓝黄(B-Y)视野检查和 Farnsworth-Munsell 100色调试验。通过临床和电生理检查确诊为CSNB1。对12名年龄匹配的正常对照受试者和另外7名高度近视的正常受试者进行了测试。
通过Farnsworth-Munsell 100色调试验,所有CSNB1患者的色觉均正常。B-Y视野检查表明,CSNB1患者在注视区域的蓝视锥细胞敏感性正常,但与正常和近视受试者相比,整个60度视野、中央0度至15度以及15度至30度环的平均敏感性显著降低。与正常和近视对照受试者相比,CSNB1患者在B-Y视野检查中15度至30度与0度至15度之间的敏感性差异显著增加。
我们的视野检查结果表明,CSNB1患者的S-视锥细胞功能仅在中央凹得以保留,而在周边视网膜则出现异常。这就解释了主要检测中央凹功能的色觉正常,以及主要源于周边视网膜的不可记录的S-视锥细胞ERG。