Nagasaka Kazuko, Horiguchi Masayuki, Shimada Yoshiaki, Yuzawa Mitsuko
Department of Ophthalmology, Nippon University School of Medicine, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2003 Apr;44(4):1673-9. doi: 10.1167/iovs.02-0885.
To study multifocal electroretinograms (mfERG) in patients with early-stage central alveolar choroidal dystrophy (CACD) with well-demarcated atrophic areas.
Eight eyes of eight patients with CACD (ages, 47-67 years) and 20 normal control subjects were examined. The first- and second-order kernels (K1 and K2) were extracted from the responses elicited by 61 standard hexagonal elements of a visual response imaging system. The amplitudes and peak times of the focal responses at various retinal eccentricities were studied.
The amplitudes of K1 were reduced in the visibly atrophic areas, and they were also decreased in areas with no visible atrophy. The peak time was slightly delayed in many loci, but the delay was not as long as that in congenital stationary night blindness or diabetic retinopathy. The amplitude of K2 was very small in the central and peripheral areas, but the K2/K1 ratio in both areas was not significantly reduced, compared with that in normal subjects.
Although the atrophic area was ophthalmoscopically well demarcated in patients with CACD, the abnormality of retinal function extended beyond the borders of the ophthalmoscopic and angiographic lesions. The retinal dysfunction outside the atrophic areas suggests a centrifugal progression of the disease, and abnormal K2 and K1 with preserved K2/K1 ratio are consistent with a presynaptic mechanism for the retinal dysfunction in this disease.
研究早期中央肺泡脉络膜营养不良（CACD）且萎缩区域界限清晰的患者的多焦视网膜电图（mfERG）。
对8例CACD患者（年龄47 - 67岁）的8只眼和20名正常对照者进行检查。从视觉反应成像系统的61个标准六边形单元所引发的反应中提取一阶和二阶核（K1和K2）。研究不同视网膜离心度处局部反应的振幅和峰值时间。
在明显萎缩区域K1的振幅降低，在无明显萎缩的区域其振幅也降低。在许多位点峰值时间稍有延迟，但延迟程度不如先天性静止性夜盲或糖尿病视网膜病变那么长。中央和周边区域K2的振幅非常小，但与正常受试者相比，这两个区域的K2/K1比值没有显著降低。
尽管CACD患者的萎缩区域在检眼镜下界限清晰，但视网膜功能异常超出了检眼镜和血管造影病变的边界。萎缩区域外的视网膜功能障碍提示疾病呈离心性进展，K2和K1异常但K2/K1比值保留与该疾病视网膜功能障碍的突触前机制一致。
