Bartz-Schmidt K U, Walter P, Krott R, Brunner R, Esser P, Heimann K
Universitäts-Augenklinik Köln.
Klin Monbl Augenheilkd. 1996 Apr;208(4):224-8. doi: 10.1055/s-2008-1035200.
In clinical practice the electroretinogram (ERG) usually should not be recorded immediately after conventional fluorescein angiography (FLA), because of the bleaching effects of strong light exposure on the course of dark adaptation and on the ERG. Currently it is not known, if indocyaningreen (ICG) angiography using the Heidelberg Retina Angiograph (HRA) has similar effects on the outer retina and if therefore the ERG should also not be recorded after ICG angiography.
Eight patients with different retinal diseases were examined. After 5 minutes of light adaptation to 160 cd/m2, Ganzfeld ERGs were repeatedly recorded using DTL electrodes during a 30 minutes dark period with a flash luminance of 0.1 cds/.m2. After this dark adaptation period a standardized ERG was recorded according to the ISCEV recommendations. This procedure was followed either by ICG angiography using the HRA or by conventional fluorescein angiography using the Canon CF 60 fundus camera. Within an interval of 5 minutes the above mentioned ERG procedure was repeated.
ICG angiography using the HRA did neither affect the course of dark adaptation as measured by increasing b-wave amplitudes during the 30 minutes dark adaptation period, nor the values for each response of the Ganzfeld standard ERG. FLA did neither affect b-wave responses to dim stimuli, nor to stronger stimuli in the scotopic range. However, the course of dark adaptation was significantly prolonged after FLA. The maximum b-wave was not affected.
ICG angiography using the HRA could be performed prior to the recording of the ERG, without any effect on the ERG. In contrast conventional FLA must be performed after ERG recordings, in order not to alter the electrophysiological responses.
在临床实践中,由于强光照射对暗适应过程和视网膜电图(ERG)有漂白作用,通常不应在传统荧光素血管造影(FLA)后立即记录ERG。目前尚不清楚使用海德堡视网膜血管造影仪(HRA)进行的吲哚菁绿(ICG)血管造影对视网膜外层是否有类似影响,以及因此在ICG血管造影后是否也不应记录ERG。
对8例患有不同视网膜疾病的患者进行检查。在适应160 cd/m²的光照5分钟后,使用DTL电极在30分钟的暗适应期内,以0.1 cds/.m²的闪光亮度重复记录全视野ERG。在这个暗适应期后,根据国际临床视觉电生理学会(ISCEV)的建议记录标准化ERG。此程序之后,要么使用HRA进行ICG血管造影,要么使用佳能CF 60眼底相机进行传统荧光素血管造影。在5分钟的间隔内重复上述ERG程序。
使用HRA进行的ICG血管造影既不影响通过在30分钟暗适应期内增加b波振幅测量的暗适应过程,也不影响全视野标准ERG的每个反应值。FLA既不影响对暗刺激的b波反应,也不影响在暗视范围内对较强刺激的b波反应。然而,FLA后暗适应过程明显延长。最大b波不受影响。
使用HRA进行ICG血管造影可在记录ERG之前进行,对ERG没有任何影响。相比之下,传统FLA必须在ERG记录之后进行,以免改变电生理反应。