Murai Ken-Ichi, Tazawa Yutaka, Kobayashi Masaki, Hayasaka Akira
Department of Ophthalmology, Iwate Medical University School of Medicine, Morioka, Japan.
Jpn J Ophthalmol. 2004 May-Jun;48(3):215-21. doi: 10.1007/s10384-003-0042-y.
To determine whether the amplitude of the s-wave on a multifocal electroretinogram (mfERG) is correlated with the degree of visual field depression in eyes with glaucoma.
Twenty patients (20 eyes) with glaucoma,ages 46 to 69 years, were studied. Twenty healthy volunteers (20 eyes) with normal intraocular pressure and with no eye diseases served as controls. The retinal sensitivities of the upper and lower visual fields of the glaucomatous eyes were determined with a Humphrey Field Analyzer. The severity of retinal sensitivity depression was rated as mild (Group A), intermediate (Group B), or severe (Group C). To record the s-wave, mfERGs were elicited by pseudorandom stimulation, with the stimulus alternating according to a binary m-sequence for base periods (bpds) of 13.3, 26.7, 53.3, 106.7, and 213.3 ms. The mfERGwaves recorded from the upper and lower visual field were summed separately.
In the control group, the s-wave in the summed mfERG was observed in all visual field halves at all bpds 53.3 ms or longer. The s-wave amplitude at a bpd of 213.3 ms was significantly larger than that at a bpd of 53.3 ms ( P < 0.05). The s-wave was also present in the glaucoma patients' eyes, and the s-wave amplitude increased as the bpd increased. At bpds of 53.3, 106.7, and 213.3-ms, the mean s-wave amplitudes in Groups B and C were significantly smaller than those in the control group ( P < 0.05, 0.01, and 0.05, respectively). At bpds of 53.3 and 106.7 ms, the mean amplitude of the s-waves in Group C was significantly smaller than that in Group A ( P < 0.05). At a bpd of 106.7 ms, a significant correlation was observed between the retinal sensitivity and the s-wave amplitude ( P < 0.05).
The significant correlation between the retinal sensitivity and the amplitude of the swave at a bpd of 106.7 ms supports the suggestion that the s-wave originates from the retinal ganglion cells and their axons. The amplitude of the s-wave may serve as an objective indicator of the severity of retinal ganglion cell damage.
确定多焦视网膜电图(mfERG)中s波的振幅是否与青光眼患者的视野缺损程度相关。
研究了20例年龄在46至69岁之间的青光眼患者(20只眼)。20名眼压正常且无眼部疾病的健康志愿者(20只眼)作为对照。使用Humphrey视野分析仪测定青光眼患者上下视野的视网膜敏感度。视网膜敏感度降低的严重程度分为轻度(A组)、中度(B组)或重度(C组)。为记录s波,通过伪随机刺激诱发mfERG,刺激根据13.3、26.7、53.3、106.7和213.3毫秒的二进制m序列在基期(bpds)交替。分别对上下视野记录的mfERG波进行求和。
在对照组中,在所有53.3毫秒或更长的bpds时,在所有视野半侧均观察到总和mfERG中的s波。213.3毫秒bpd时的s波振幅显著大于53.3毫秒bpd时的s波振幅(P<0.05)。青光眼患者眼中也存在s波,且s波振幅随bpd增加而增加。在53.3、106.7和213.3毫秒的bpds时,B组和C组的平均s波振幅显著小于对照组(分别为P<0.05、0.01和0.05)。在53.3和106.7毫秒的bpds时,C组的s波平均振幅显著小于A组(P<0.05)。在106.7毫秒的bpd时,观察到视网膜敏感度与s波振幅之间存在显著相关性(P<0.05)。
在106.7毫秒bpd时视网膜敏感度与s波振幅之间的显著相关性支持了s波起源于视网膜神经节细胞及其轴突的观点。s波振幅可作为视网膜神经节细胞损伤严重程度的客观指标。