Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Invest Ophthalmol Vis Sci. 2012 Jun 14;53(7):3562-9. doi: 10.1167/iovs.12-9762.
To evaluate the functional changes in various morphologic types of idiopathic epiretinal membrane (ERM) by multifocal electroretinography (mfERG) and spectral-domain optical coherence tomography (SD-OCT).
All patients (n = 71) with unilateral idiopathic ERM underwent complete ophthalmologic examination, including measurements of best-corrected visual acuity (BCVA), SD-OCT, and mfERG for both eyes. To classify idiopathic ERM by subtype, the morphologic characteristics of the foveal area on representative scanned images were assessed. The five subtypes by foveal SD-OCT morphology included fovea-attached ERM with outer retinal thickening and minimal inner retinal change (Group 1A), outer retinal inward projection and inner retinal thickening (Group 1B), and prominent thickening of inner retinal layer (Group 1C) and foveal sparing ERM with formation of macular pseudohole (Group 2A) and with schisislike, intraretinal splitting (Group 2B).
On mfERG, P1 amplitude density in the central ring (R1) and inter-eye (affected eye/fellow eye) response ratio of P1 amplitude density in R1 differed significantly among five groups (P = 0.032 and P = 0.022, respectively). In Group 1 patients, central subfield thickness (CST) and inner retinal layer thickness (IRT) on SD-OCT were strongly correlated with BCVA and P1 amplitude density in R1. A receiver operating characteristic (ROC) curve analysis showed that IRT had high predictive accuracy in distinguishing Groups 1A and 1B (area under the ROC curve [AUROC] = 0.966) and Groups 1B and 1C (AUROC = 1.000).
Multifocal electroretinography can be used to investigate the pathophysiology of ERM and to evaluate the degree of functional demise in the fovea on SD-OCT.
通过多焦视网膜电图（mfERG）和频域光学相干断层扫描（SD-OCT）评估各种形态类型特发性视网膜前膜（ERM）的功能变化。
所有单侧特发性 ERM 患者（n=71）均行全面眼科检查，包括最佳矫正视力（BCVA）、SD-OCT 和双眼 mfERG 测量。为了通过亚型对特发性 ERM 进行分类，评估代表性扫描图像中黄斑区的形态特征。根据 foveal SD-OCT 形态学特征，将特发性 ERM 分为 5 个亚型：伴有外视网膜增厚和最小内视网膜改变的 fovea-attached ERM（1A 组）、外视网膜向内突起和内视网膜增厚（1B 组）、内视网膜层显著增厚（1C 组）和黄斑假性孔形成的 foveal 保留 ERM（2A 组）以及伴分裂样、内视网膜分裂的 foveal 保留 ERM（2B 组）。
在 mfERG 中，中央环（R1）的 P1 幅度密度和 R1 中 P1 幅度密度的眼间（受影响眼/对侧眼）反应比在 5 组之间差异有统计学意义（P=0.032 和 P=0.022）。在 1 组患者中，SD-OCT 上中央视网膜神经纤维层厚度（CST）和内视网膜层厚度（IRT）与 BCVA 和 R1 中的 P1 幅度密度呈强相关。ROC 曲线分析显示，IRT 对内 1A 组和 1B 组（ROC 曲线下面积[AUROC] = 0.966）和 1B 组和 1C 组（AUROC = 1.000）的鉴别具有较高的预测准确性。
多焦视网膜电图可用于研究 ERM 的病理生理学，并评估 SD-OCT 上黄斑区功能丧失的程度。
