Zacks David N, Samson C Michael, Loewenstein John, Foster C Stephen
Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA.
Graefes Arch Clin Exp Ophthalmol. 2002 Aug;240(8):601-7. doi: 10.1007/s00417-002-0506-7. Epub 2002 Jul 10.
To determine whether electroretinogram results can help predict the success in tapering of immunosuppressive medication in patients with birdshot retinochoroidopathy.
Fifteen patients with birdshot retinochoroidopathy who had at least three serial electroretinograms (ERG) during the course of their disease were included in the study. Charts of patients seen at the Immunology and Uveitis Service at the Massachusetts Eye and Ear Infirmary, Boston, Massachusetts were retrospectively reviewed. Seven parameters of the ERGs were examined: dim scotopic amplitude, bright scotopic amplitude, bright scotopic implicit time, single-flash photopic amplitude, single-flash photopic implicit time, 30 Hz flicker amplitudes, and 30 Hz flicker implicit times. For each parameter the patients were divided into two groups, those with normal and those with abnormal responses at the time their immunosuppressive medication taper was initiated. The percentage of patients in each group who were able to successfully taper their immunosuppressive medication was calculated. A successful taper of medication was defined as no recurrence of disease signs or symptoms for at least 1 year after the medication was terminated.
Abnormalities in the bright scotopic response amplitudes and 30 Hz flicker implicit times were associated with recurrence of inflammation as immunosuppressive therapy was tapered.
ERG can serve as a useful adjunct in helping determine when to initiate tapering of immunosuppressive therapy in patients with birdshot retinochoroidopathy.
确定视网膜电图结果是否有助于预测鸟枪弹样视网膜脉络膜病变患者免疫抑制药物减量的成功与否。
本研究纳入了15例在疾病过程中至少有三次连续视网膜电图（ERG）检查结果的鸟枪弹样视网膜脉络膜病变患者。对在马萨诸塞州波士顿市马萨诸塞眼耳医院免疫与葡萄膜炎科就诊患者的病历进行了回顾性分析。检查了ERG的七个参数：暗视暗适应振幅、明视暗适应振幅、明视暗适应潜伏时间、单闪光明视振幅、单闪光明视潜伏时间、30Hz闪烁振幅和30Hz闪烁潜伏时间。对于每个参数，将患者分为两组，即在开始免疫抑制药物减量时反应正常和异常的患者。计算每组中能够成功减量免疫抑制药物的患者百分比。药物减量成功的定义为在药物停用后至少1年内疾病体征或症状未复发。
随着免疫抑制治疗的减量，明视暗适应反应振幅和30Hz闪烁潜伏时间异常与炎症复发相关。
视网膜电图可作为一种有用的辅助手段，帮助确定鸟枪弹样视网膜脉络膜病变患者何时开始免疫抑制治疗的减量。
