Coupland S G, Kirkham T H
Can J Neurol Sci. 1982 Aug;9(3):325-30. doi: 10.1017/s0317167100044152.
We studied the flash electroretinograms (ERGs) of 105 patients with multiple sclerosis who were divided into four groups. The first group had no history or clinical evidence of optic nerve dysfunction, the second and third groups had either left or right optic nerve disease respectively, and the fourth group had historical or clinical evidence of bilateral optic nerve disease. Statistical analysis of the data using analysis of variance (ANOVA) showed that the group of patients with no history or clinical evidence of optic nerve disease had no significant difference from the control group for their peak b-wave implicit times but the other three groups were significantly delayed on the affected side(s). Using the Mann-Whitney U-test we found all four patient groups had significantly greater absolute interocular latency differences from the control group. The electroretinal contribution to flash VEP delay was also investigated. In those patients with unilateral or bilateral optic nerve disease we found that in 14-31% of those patients with flash VEP delay there was also abnormal prolongation of the ERG b-wave. These results confirm a high incidence of retinal dysfunction in multiple sclerosis patients and may suggest that transynaptic degeneration of retinal structures occurs in optic nerve demyelination. The significant absolute interocular latency difference in particular may provide another electrophysiological parameter to establish a diagnosis of multiple sclerosis in suspect cases.
我们研究了105例多发性硬化症患者的闪光视网膜电图（ERG），这些患者被分为四组。第一组没有视神经功能障碍的病史或临床证据，第二组和第三组分别患有左侧或右侧视神经疾病，第四组有双侧视神经疾病的病史或临床证据。使用方差分析（ANOVA）对数据进行统计分析表明，没有视神经疾病病史或临床证据的患者组，其b波峰值隐时与对照组相比无显著差异，但其他三组患侧的b波峰值隐时明显延迟。使用曼-惠特尼U检验，我们发现所有四组患者与对照组相比，双眼绝对潜伏期差异均显著更大。我们还研究了视网膜电活动对闪光视觉诱发电位（VEP）延迟的影响。在那些患有单侧或双侧视神经疾病的患者中，我们发现在14% - 31%的闪光VEP延迟患者中，ERG的b波也有异常延长。这些结果证实了多发性硬化症患者视网膜功能障碍的高发生率，并可能提示在视神经脱髓鞘过程中发生了视网膜结构的跨突触变性。特别是显著的双眼绝对潜伏期差异，可能为疑似病例的多发性硬化症诊断提供另一个电生理参数。
