Rabin Jeff, Houser Brooke, Talbert Carolyn, Patel Rue
University of the Incarnate Word Rosenberg School of Optometry, 9725 Datapoint Drive, San Antonio, TX, 78229, USA.
Doc Ophthalmol. 2017 Dec;135(3):195-208. doi: 10.1007/s10633-017-9614-x. Epub 2017 Oct 3.
Dark adaptometry (DA) is a sensitive test for diagnosis of retinal disease. Patients requiring flash electroretinograms (ERGs) benefit from DA for proper diagnosis. Our purpose was to develop a DA test to be administered during the 20-min dark adaptation period of the flash ERG ( www.iscev.org ) using alternating red and blue stimuli to bias responses in favor of cones (red) and rods (blue).
An ERG Ganzfeld was used to measure DA in 21 normal subjects and 21 patients with retinal disease. Subjects underwent 75 s of preadaptation followed by 20 min of DA using an adaptive staircase to detect alternating flashes of red and blue light. Normative red and blue DA was compared to patients at the 10-min midpoint and 20-min final threshold.
At 15 min, normals and patients showed asymptotic plateaus; hence, final thresholds were achieved within 15 min for parameters of this study. In RP and allied conditions (n = 11), 100% showed significantly elevated blue DA thresholds (> 2SD above normal) at 10 and 20 min. In cone diseases, 80% showed abnormal red DA at 10 min and 30% at 20 min, indicating that delayed adaptation is more typical of cone disease.
Two-color DA is expediently measured during the DA phase of ERGs providing clinical data which separate rod and cone dysfunction critical for accurate diagnosis of various retinal diseases. It provides an additional benchmark for monitoring function over time and invaluable guidance for patients functioning in dimly lit settings.
暗适应测量法（DA）是诊断视网膜疾病的一种敏感测试。需要闪光视网膜电图（ERG）检查的患者可通过DA进行准确诊断。我们的目的是开发一种DA测试，在闪光ERG（www.iscev.org）的20分钟暗适应期内进行，使用交替的红色和蓝色刺激，使反应偏向视锥细胞（红色）和视杆细胞（蓝色）。
使用ERG全视野刺激器测量21名正常受试者和21名视网膜疾病患者的DA。受试者先进行75秒的预适应，然后使用自适应阶梯法进行20分钟的DA测试，以检测红色和蓝色光的交替闪光。将正常受试者的红色和蓝色DA规范值与患者在10分钟中点和20分钟最终阈值时的情况进行比较。
在15分钟时，正常受试者和患者均显示出渐近平台期；因此，本研究参数在15分钟内达到最终阈值。在视网膜色素变性及相关病症（n = 11）中，100%的患者在10分钟和20分钟时蓝色DA阈值显著升高（高于正常2个标准差以上）。在视锥细胞疾病中，80%的患者在10分钟时红色DA异常，20分钟时为30%，这表明延迟适应在视锥细胞疾病中更为典型。
在ERG的DA阶段方便地测量双色DA，可提供临床数据，区分视杆细胞和视锥细胞功能障碍，这对准确诊断各种视网膜疾病至关重要。它为长期监测功能提供了额外的基准，为在昏暗环境中活动的患者提供了宝贵的指导。
