Gundogan Fatih C, Isilak Zafer, Erdurman Cuneyt, Mumcuoglu Tarkan, Durukan Ali H, Bayraktar Mehmet Z
Department of Ophthalmology, Gulhane Military Medical School, Ankara, Turkey.
Clin Exp Hypertens. 2008 Jul;30(5):375-84. doi: 10.1080/10641960802275148.
To investigate the local retinal dysfunctions in mild to moderate essential hypertensive patients by using multifocal electroretinogram (mfERG).
Thirty-one patients with stage 1 or stage 2 hypertension (HT) and 31 age- and sex-matched healthy normotensive (NT) subjects were included. Fourteen of the patients had stage 1 and 17 had stage 2 hypertension. Twenty had grade 1 and 11 had grade 2 hypertensive retinopathy. The local retinal functions from the fovea to the peripheral 30 degrees were evaluated by multifocal electroretinogram by dividing this area to central hexagonal area (CH) and four concentric rings around the central hexagon (Rings 1-4). The amplitude and the implicit times of the positive peak (P1) and the negative peak (N1) of the responses were compared between the control subjects and hypertensive patients. Only the right eyes were included. The differences between the hypertensive patients and control subjects were investigated using independent samples t test, and the differences between grade 1 and grade 2 hypertensive retinopathy and stage 1 and stage 2 hypertension were investigated using Mann-Whitney U test.
P1 amplitudes in CH (HT: 129.0 +/- 29.5, NT: 149.1 +/- 45.5, p = 0.043) and in Ring 3 (HT: 37.0 +/- 8.0, NT: 41.7 +/- 7.8, p = 0.024) and N1 amplitude in Ring 1 (HT: 26.8 +/- 7.4, NT: 30.8 +/- 7.8, p = 0.048) in the hypertensive patients was significantly reduced when compared to healthy normotensive subjects. There was no significant difference in terms of P1 and N1 implicit times. There was also no significant difference between the patients with stage 1 or stage 2 hypertension and patients with grade 1 or grade 2 hypertensive retinopathy.
Hypertensive subjects have local retinal dysfunctions with respect to healthy controls. This result probably originated from retinal ischemia due to changes in retinal and/or choroidal circulation in systemic arterial hypertension.
通过多焦视网膜电图（mfERG）研究轻度至中度原发性高血压患者的局部视网膜功能障碍。
纳入31例1期或2期高血压（HT）患者和31例年龄及性别匹配的健康血压正常（NT）受试者。其中14例患者为1期高血压，17例为2期高血压。20例有1级高血压视网膜病变，11例有2级高血压视网膜病变。通过多焦视网膜电图评估从中央凹到周边30度的局部视网膜功能，将该区域划分为中央六边形区域（CH）和围绕中央六边形的四个同心环（环1 - 4）。比较对照组和高血压患者反应的正峰（P1）和负峰（N1）的振幅及隐含时间。仅纳入右眼。使用独立样本t检验研究高血压患者与对照组之间的差异，使用曼 - 惠特尼U检验研究1级和2级高血压视网膜病变以及1期和2期高血压患者之间的差异。
与健康血压正常受试者相比，高血压患者CH区域的P1振幅（HT：129.0±29.5，NT：149.1±45.5，p = 0.043）、环3区域的P1振幅（HT：37.0±8.0，NT：41.7±7.8，p = 0.024）以及环1区域的N1振幅（HT：26.8±7.4，NT：30.8±7.8，p = 0.048）显著降低。P1和N1隐含时间方面无显著差异。1期或2期高血压患者与伴有1级或2级高血压视网膜病变的患者之间也无显著差异。
高血压受试者相对于健康对照存在局部视网膜功能障碍。这一结果可能源于系统性动脉高血压导致的视网膜和/或脉络膜循环改变引起视网膜缺血。
