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非感染性葡萄膜炎常伴有视网膜电图异常。

Electroretinogram abnormalities in non-infectious uveitis often persist.

机构信息

Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, the Netherlands.

Bartiméus Diagnostic Centre for complex visual disorders, Zeist, The Netherlands.

出版信息

Acta Ophthalmol. 2020 Sep;98(6):627-633. doi: 10.1111/aos.14401. Epub 2020 Mar 19.

Abstract

PURPOSE

In uveitis, a prolonged implicit time of the cone b-wave is a characteristic electroretinogram (ERG) abnormality. We investigated whether this can improve or deteriorate over time and which clinical factors are associated with change.

METHODS

Prospective cohort study. Patients with a non-infectious uveitis were included. An ERG was measured in the first year of uveitis onset and a follow-up ERG one year later. Changes in the implicit time of the cone b-wave were investigated in relation to clinical parameters including the following: demographics, uveitis characteristics, treatment, best-corrected visual acuity, optical coherence tomography parameters and fluorescein angiography scores.

RESULTS

Of 98 eyes (63 patients), 40 showed a prolonged cone b-wave on the first ERG, which improved in 10 eyes. Eyes with an improved ERG more often had a panuveitis with initially a higher incidence of cells in the anterior chamber during the first ERG, which resolved at the time of their follow-up ERG. Five of the 58 eyes with a normal first ERG had a deteriorated follow-up ERG. These eyes had more frequently an active uveitis at the time of the follow-up ERG. Of the 78 eyes with a stable cone b-wave, 16 had a quiescent inflammation during follow-up. There were no differences in age or treatment.

CONCLUSION

In most patients with non-infectious uveitis, ERG abnormalities appear to be irreversible, even when the inflammation becomes quiescent. However, some ERGs improved, which was associated with reduction in inflammation of the anterior chamber due to panuveitis. In contrast, a worsened ERG was associated with a persistence of inflammation.

摘要

目的

葡萄膜炎患者的 cone b-波潜伏时延长是特征性的视网膜电图(ERG)异常。我们研究了这种异常是否会随时间推移而改善或恶化,以及哪些临床因素与变化相关。

方法

前瞻性队列研究。纳入非感染性葡萄膜炎患者。在葡萄膜炎发病的第一年测量 ERG,并在一年后进行随访 ERG。研究 cone b-波潜伏时的变化与临床参数的关系,包括:人口统计学、葡萄膜炎特征、治疗、最佳矫正视力、光学相干断层扫描参数和荧光素血管造影评分。

结果

98 只眼(63 例患者)中,40 只眼在首次 ERG 时出现 cone b-波潜伏期延长,其中 10 只眼改善。改善的 ERG 眼更常发生全葡萄膜炎,首次 ERG 时前房细胞初始发生率较高,在随访 ERG 时得到缓解。58 只首次 ERG 正常的眼中有 5 只出现随访 ERG 恶化。这些眼在随访 ERG 时更常发生活动性葡萄膜炎。78 只 cone b-波稳定的眼中,16 只在随访期间有静止性炎症。年龄或治疗无差异。

结论

在大多数非感染性葡萄膜炎患者中,即使炎症静止,ERG 异常似乎也是不可逆的。然而,一些 ERG 改善,这与全葡萄膜炎引起的前房炎症减少有关。相比之下,ERG 恶化与炎症持续存在相关。

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