Department of Ophthalmology, Glostrup Hospital, Glostrup, Denmark.
Invest Ophthalmol Vis Sci. 2010 Apr;51(4):1806-10. doi: 10.1167/iovs.09-4555. Epub 2009 Nov 20.
Purpose. To examine retinal function in chronic ocular ischemia using multifocal electroretinography (mfERG). Methods. Thirteen patients with unilateral ocular ischemic syndrome (OIS) underwent assessment of ophthalmic systolic blood pressure by ocular pneumoplethysmography, carotid artery patency by ultrasonography, intraocular pressure (IOP) by applanation tonometry, retinal perfusion by fluorescein angiography, and retinal function by mfERG. Results. Ophthalmic systolic blood pressure was 67.0 +/- 11.6 mm Hg in eyes with OIS and 106.1 +/- 18.0 mm Hg in fellow eyes, whereas IOP was 13.8 +/- 3.2 and 14.4 +/- 1.7 mm Hg, respectively. Summed mfERG implicit times (N1, P1, N2) were prolonged in eyes with OIS, by 7.6%, 6.2%, and 7.5%, respectively, compared with fellow eyes (P < or = 0.0048). The retardation of retinal function was significant outside the macula, whereas the assessment of responses from the central retina was limited by high variance. Second-order kernel (first slice) summed implicit times (N1, P1, N2) were also prolonged in OIS, by 6.6%, 7.3%, and 6.8%, respectively (P < or = 0.0058). Of the amplitudes, only the second-order N2 amplitude was significantly abnormal, being reduced by 23.2% in OIS (P = 0.011). Conclusions. The function of the outer and middle layers of the retina was found to be suppressed in chronic ocular hypoperfusion. The moderate delay in retinal function does not appear to explain the prominent photopic symptom of diffuse glare in bright light, and the delay could be evidence of a functional adaptation that serves to maintain and optimize signaling under conditions of compromised perfusion. (ClinicalTrials.gov number, NCT00403195.).
目的。使用多焦视网膜电图（mfERG）检查慢性眼缺血的视网膜功能。方法。 13 例单侧眼缺血综合征（OIS）患者接受了眼气动血压测量（通过眼气动血压测量），颈动脉通畅性超声检查，眼压（IOP）通过眼压计测量，视网膜灌注通过荧光素血管造影检查，视网膜功能通过 mfERG 检查。结果。 OIS 眼中的眼动脉收缩压为 67.0 +/- 11.6 mmHg，对侧眼为 106.1 +/- 18.0 mmHg，而眼压分别为 13.8 +/- 3.2 和 14.4 +/- 1.7 mmHg。与对侧眼相比，OIS 眼中的总和 mfERG 隐时（N1、P1、N2）分别延长了 7.6％、6.2％和 7.5％（P<或=0.0048）。视网膜功能的延迟在外周部明显，而中央视网膜的反应评估受到高变异性的限制。第二阶核（第一片）总和隐时（N1、P1、N2）在 OIS 中也分别延长了 6.6％、7.3％和 6.8％（P<或=0.0058）。在幅度方面，只有二阶 N2 幅度明显异常，OIS 中降低了 23.2％（P=0.011）。结论。在慢性眼低灌注中发现外核层和中层的功能受到抑制。视网膜功能的适度延迟似乎并不能解释在强光下弥漫性眩光的明显光幻视症状，而延迟可能是在灌注受损的情况下维持和优化信号的功能适应的证据。（临床试验.gov 编号，NCT00403195.）。
