Lüke C, Lüke M, Aisenbrey S, Dietlein T S, Bartz-Schmidt K U, Kirchhof B, Walter P
Zentrum für Augenheilkunde der Universität Köln, ERG-Labor Joseph-Stelzmann-Strasse 9, 50924 Köln.
Klin Monbl Augenheilkd. 2007 Feb;224(2):120-6. doi: 10.1055/s-2007-962956.
The aim of the present study was to evaluate potential electrophysiological changes after 360 degrees retinotomy and macular translocation for subfoveal choroidal neovascularisation in patients with age-related macular degeneration.
A consecutive series of 32 patients suffering from subfoveal choroidal neovascularisation secondary to age-related macular degeneration underwent 360 degrees retinotomy and macular translocation. The scotopic triple-flash ERG (TERG) served as the main parameter of the study and was recorded one day prior to the translocation surgery and no earlier than 4 weeks after the silicone oil removal.
The TERG amplitudes were significantly reduced after translocation surgery. Depending on the applied flash luminance the mean amplitude reduction of the first b-wave varied between 67 % (0.2 cds/m (2)) and 74 % (0.03 cds/m (2)). The latency of the second b-wave of the preoperative TERG proved to have predictive power with reference to the postoperative visual acuity. A statistically significant correlation between the latency of the second b-wave for a flash intensity of 0.03 and 0.1 cds/m (2) and the postoperative visual acuity was shown (p = 0,016 and p = 0,049).
In accordance with previous studies the present study indicates that a significant electrophysiological decrease is caused by surgical procedures associated with macular translocation. In future, due to predictive parameters of the TERG the preoperative selection of patients could be improved.
本研究的目的是评估年龄相关性黄斑变性患者行360度视网膜切开术和黄斑转位术后潜在的电生理变化,用于治疗黄斑下脉络膜新生血管。
连续32例年龄相关性黄斑变性继发黄斑下脉络膜新生血管的患者接受了360度视网膜切开术和黄斑转位术。暗适应三闪光视网膜电图(TERG)作为主要研究参数,在转位手术前一天及硅油取出后不早于4周记录。
转位手术后TERG振幅显著降低。根据所应用的闪光亮度,第一个b波的平均振幅降低在67%(0.2坎德拉/平方米)至74%(0.03坎德拉/平方米)之间。术前TERG第二个b波的潜伏期被证明对术后视力具有预测作用。在闪光强度为0.03和0.1坎德拉/平方米时,第二个b波的潜伏期与术后视力之间存在统计学显著相关性(p = 0.016和p = 0.049)。
与先前研究一致,本研究表明黄斑转位相关手术会导致明显的电生理下降。未来,由于TERG的预测参数,患者的术前选择可能会得到改善。