Feigl Beatrix, Brown Brian, Lovie-Kitchin Jan, Swann Peter
Centre for Health Research, School of Optometry, Queensland University of Technology, Brisbane, Australia.
Invest Ophthalmol Vis Sci. 2005 Dec;46(12):4722-7. doi: 10.1167/iovs.05-0795.
To investigate the global-flash multifocal electroretinogram (mfERG) in early age-related maculopathy (ARM).
Thirty-two eyes from 20 healthy control subjects and 12 age-matched subjects with early ARM were investigated with the conventional and the global-flash mfERG. Early ARM subjects were graded according to an international grading system. The conventional mfERG consisted of 103 hexagons flickering according to a pseudorandom m-sequence. The global-flash mfERG paradigm used four frames starting with the conventional m-sequence stimulation, followed by a dark frame, a global flash, and another dark frame. The responses include a direct response (DR) and a later induced component (IC). The first-order kernel peak-to-trough response densities of the conventional mfERG (N1P1), the global-flash DR and IC, and the implicit times of the conventional P1, global-flash DR, and IC peak were analyzed after averaging the results into five groups according to five field locations: a central area and four quadrants.
There was a significant reduction of the global-flash mfERG DR response density (P < or = 0.05) in the early ARM group compared with the control group. Neither the IC response density nor DR and IC implicit times were significantly impaired. However, the superior retina showed longer implicit times than did the inferior retina for the DR in the early ARM group. There was no significant correlation between funduscopic features and the central averaged responses of the global-flash mfERG (for the DR response density: r = -0.19, P = 0.3, or for the DR implicit time: r = -0.18, P = 0.3). None of the conventional mfERG parameters was significantly different between the two groups.
The global-flash mfERG detects deficits in early ARM before the conventional mfERG. Retinal ischemia may play a role in producing function impairment in ARM.
研究早期年龄相关性黄斑病变（ARM）的全视野闪烁多焦视网膜电图（mfERG）。
对20名健康对照者的32只眼和12名年龄匹配的早期ARM患者进行传统和全视野闪烁mfERG检查。早期ARM患者根据国际分级系统进行分级。传统mfERG由103个六边形按照伪随机m序列闪烁组成。全视野闪烁mfERG模式使用四个帧，开始是传统m序列刺激，接着是一个暗帧、一次全视野闪光和另一个暗帧。反应包括一个直接反应（DR）和一个后期诱发成分（IC）。根据五个视野位置（一个中心区域和四个象限）将结果平均分为五组后，分析传统mfERG（N1P1）、全视野闪烁DR和IC的一阶核峰谷反应密度以及传统P1、全视野闪烁DR和IC峰的潜伏期。
与对照组相比，早期ARM组全视野闪烁mfERG的DR反应密度显著降低（P≤0.05）。IC反应密度以及DR和IC潜伏期均无明显受损。然而，早期ARM组中，上半视网膜的DR潜伏期比下半视网膜更长。眼底特征与全视野闪烁mfERG的中心平均反应之间无显著相关性（DR反应密度：r = -0.19，P = 0.3；DR潜伏期：r = -0.18，P = 0.3）。两组之间传统mfERG的参数均无显著差异。
全视野闪烁mfERG比传统mfERG能更早检测到早期ARM的缺陷。视网膜缺血可能在ARM功能损害中起作用。
