Smirnova T V, Sheludchenko V M, Kozlovskaya N L, Budzinskaya M V, Velieva I A
Research Institute of Eye Diseases, 11 A,B Rossolimo St., Moscow, Russia, 119021.
I.M. Sechenov First Moscow State Medical University 11 str. 4 Rossolimo St, Moscow, Russia, 119991.
Vestn Oftalmol. 2017;133(3):22-29. doi: 10.17116/oftalma2017133322-29.
to evaluate the functional state of the retina in patients with antiphospholipid syndrome (APS) through different types of electroretinography (ERG).
The total ERG (t-ERG), local macular ERG (m-ERG), and oscillatory potentials (OP) were recorded in 56 patients with verified APS.
In most patients with APS, ERG was of abnormal appearance, particularly, t-ERG was notable for reliably lower a- and b-wave amplitudes (70% of cases), m-ERG - for lower amplitudes and shorter latency (64% of cases). Pathological changes of t-ERG and m-ERG components were equally common in patients with and without retinal vascular occlusions. Linear dependence was established between the decrease in b-wave amplitude of subnormal t-ERG and the Vs value in the central retinal artery. A decrease in the OP index and OP configuration distortion were found in 82% of patients. At that, OP indices tended to be lower in patients from the retinal vascular occlusions group.
The use of different types of ERG enable detection of not only local, but also generalized retinal changes in APS. Regardless of the presence of retinal occlusion, APS patients show suppression of biopotential in most of cellular elements of the retina due to ischemia. Despite high visual acuity, the local macular potential gets significantly reduced in more than half of APS patients. Oscillatory potentials recording is a highly sensitive method for diagnosis of retinal ischmia in APS.
通过不同类型的视网膜电图（ERG）评估抗磷脂综合征（APS）患者视网膜的功能状态。
对56例确诊为APS的患者记录了全视网膜电图（t - ERG）、局部黄斑视网膜电图（m - ERG）和振荡电位（OP）。
大多数APS患者的ERG表现异常，特别是t - ERG的a波和b波振幅显著降低（70%的病例），m - ERG的振幅降低且潜伏期缩短（64%的病例）。t - ERG和m - ERG成分的病理变化在有和没有视网膜血管阻塞的患者中同样常见。在异常t - ERG的b波振幅降低与视网膜中央动脉的Vs值之间建立了线性关系。82%的患者发现OP指数降低和OP形态畸变。此时，视网膜血管阻塞组患者的OP指数往往较低。
使用不同类型的ERG不仅能够检测APS患者局部视网膜变化，还能检测全身性视网膜变化。无论是否存在视网膜阻塞，由于缺血，APS患者视网膜的大多数细胞成分的生物电位均受到抑制。尽管视力正常，但超过一半的APS患者局部黄斑电位显著降低。振荡电位记录是诊断APS患者视网膜缺血的一种高度敏感的方法。
