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[视网膜电图中的彩色光刺激用于视锥细胞营养不良的鉴别诊断]

[Colored light stimuli in ERG for differential diagnosis of cone dystrophies].

作者信息

Kellner U, Foerster M H

机构信息

Klinikum Steglitz, FU Berlin.

出版信息

Klin Monbl Augenheilkd. 1992 Aug;201(2):102-6. doi: 10.1055/s-2008-1045875.

Abstract

We recorded electroretinograms (ERG) with white and color stimuli in normal persons and four patients with cone dystrophies. Kodak Wratten-filters in blue, blue-green, green, yellow and red were used for the color flashes. ERGs to all color stimuli were recorded at dark and light adapted conditions with different stimulus intensities, to 30 Hz flicker stimulation and with special filtering for oscillatory potentials. Selective blue cone-responses were obtained using strong blue flashes at a yellow background. Patients with cone dystrophies showed slightly to moderately reduced responses at dark adaptation to blue, blue-green, green and yellow stimuli. Red stimuli elicited only small responses with a markedly delayed b-wave implicit time. The light adapted recordings, flicker responses and oscillatory potentials were reduced to all color stimuli. However, differences between patients with cone dystrophies could be detected concerning the responses to red and green. In two patients the responses were reduced to the same degree to all color stimuli. Another patient had very small responses and no oscillatory potentials to red, but his responses were only moderately reduced to green. A patient with combined red-green cone and rod dystrophy had a blue cone hypersensitivity. Responses to blue and blue-green were large at all stimulus conditions, but responses to all other stimuli were much smaller. The blue cone ERG showed a prominent blue cone response. ERG recording to colored stimuli allows a separation of retinal dysfunction in patients with cone dystrophies.

摘要

我们在正常人和四名视锥细胞营养不良患者中,使用白色和彩色刺激记录视网膜电图(ERG)。彩色闪光采用柯达雷登滤光片,分别为蓝色、蓝绿色、绿色、黄色和红色。在暗适应和明适应条件下,以不同刺激强度记录对所有彩色刺激的ERG,包括30Hz闪烁刺激,并对振荡电位进行特殊滤波。通过在黄色背景下使用强蓝色闪光获得选择性蓝锥细胞反应。视锥细胞营养不良患者在暗适应时对蓝色、蓝绿色、绿色和黄色刺激的反应略有至中度降低。红色刺激仅引起小反应,b波潜伏期明显延迟。明适应记录、闪烁反应和振荡电位对所有彩色刺激均降低。然而,在视锥细胞营养不良患者中,可检测到对红色和绿色反应的差异。两名患者对所有彩色刺激的反应降低程度相同。另一名患者对红色反应非常小且无振荡电位,但对绿色反应仅中度降低。一名患有红绿色视锥细胞和视杆细胞联合营养不良的患者存在蓝锥细胞超敏反应。在所有刺激条件下,对蓝色和蓝绿色的反应都很大,但对所有其他刺激的反应要小得多。蓝锥细胞ERG显示出明显的蓝锥细胞反应。记录对彩色刺激的ERG有助于区分视锥细胞营养不良患者的视网膜功能障碍。

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