Gerth Christina, Wright Tom, Héon Elise, Westall Carol A
Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
Invest Ophthalmol Vis Sci. 2007 Mar;48(3):1312-8. doi: 10.1167/iovs.06-0630.
To assess central retinal function in patients with advanced retinitis pigmentosa (RP) using the multifocal (mf)ERG and static perimetry.
Patients with RP; a nonrecordable, full-field (ff)ERG; and visual acuity (VA) of </= 1.0 logMAR were included. All patients underwent mfERG testing (103 hexagons, and 2.67 and 5.33 cd . s . m(-2) flash intensities) and static perimetry (103 corresponding areas) in the better eye. First-order kernel mfERGs were analyzed for total noise, signal-to-noise ratio, response amplitude, and implicit time. The number of areas with recordable mfERG responses were counted and compared with visual field (VF) sensitivity.
Twenty-nine patients aged 16 to 68 years with a VA of 0.02 to 1.0 logMAR and a kinetic VF of 10 degrees to 60 degrees in diameter were included. mfERGs were successfully performed in 22 of 29 patients. Responses were detected in at least one stimulated area in 22 of 22 patients, with an overall response detection of 9.8% in all stimulated areas and no difference between flash intensities. All responses were diminished severely in response density P1-N1, with normal P1 implicit time in 50% of the recordings. No predictive factors for recordable mfERG responses were identified. VF results were recorded reliably in 27 of 29 patients, with a 40% response detection rate.
mfERG responses were recordable in at least one area in all successfully tested patients with advanced RP. Response detection and performance was significantly higher for static perimetry. Static perimetry may be a more sensitive primary outcome measure of central vision function than the mfERG in patients with advanced RP and nonrecordable ffERGs.
使用多焦视网膜电图（mfERG）和静态视野检查评估晚期视网膜色素变性（RP）患者的中心视网膜功能。
纳入患有RP、全视野视网膜电图（ffERG）不可记录且视力（VA）≤1.0 logMAR的患者。所有患者均对较好眼进行mfERG检查（103个六边形，闪光强度分别为2.67和5.33 cd·s·m⁻²）和静态视野检查（103个相应区域）。分析一阶核mfERG的总噪声、信噪比、反应幅度和隐含时间。统计可记录mfERG反应的区域数量，并与视野（VF）敏感度进行比较。
纳入29例年龄在16至68岁之间的患者，VA为0.02至1.0 logMAR，动态VF直径为10度至60度。29例患者中有22例成功进行了mfERG检查。22例患者中至少在一个刺激区域检测到反应，所有刺激区域的总体反应检测率为9.8%，闪光强度之间无差异。所有反应在反应密度P1-N1中均严重减弱，50%的记录中P1隐含时间正常。未发现可记录mfERG反应的预测因素。29例患者中有27例可靠记录了VF结果，反应检测率为40%。
在所有成功检测的晚期RP患者中，至少在一个区域可记录到mfERG反应。静态视野检查的反应检测和表现明显更高。对于晚期RP且ffERG不可记录的患者，静态视野检查可能是比mfERG更敏感的中心视觉功能主要结局指标。
