Seeliger M, Kretschmann U, Apfelstedt-Sylla E, Rüther K, Zrenner E
Department of Pathophysiology of Vision and Neuroophthalmology, University Eye Hospital, Tübingen, Germany.
Am J Ophthalmol. 1998 Feb;125(2):214-26. doi: 10.1016/s0002-9394(99)80094-4.
To investigate the diagnostic potential of multifocal electroretinography for the evaluation of retinal affection by retinitis pigmentosa in a clinical setting.
For this prospective study, multifocal electroretinograms were obtained from 38 patients who matched the inclusion criteria of either a detectable photopic Ganzfeld response or visual fields of 10 degrees or more, and from 30 normal volunteers. Recordings were performed with the visual evoked response imaging system, using a resolution of 61 hexagonal elements within a 30-degree visual field. The results of the left eye of each patient and control subject were used for statistical evaluation by the Mann-Whitney U test.
The 38 eligible patients included those with Usher syndrome types I and II (one patient and six patients, respectively) and those with autosomal-recessive (18), X-recessive (two), and autosomal-dominant (11) forms of retinitis pigmentosa. In 27 (71%) of these 38 patients, at least a central response of the multifocal electroretinogram was detectable. Loss of multifocal electroretinogram response density in patients with retinitis pigmentosa was significant (P < .00001) in all five eccentricity groups (concentric rings), with a progression from center to periphery. Implicit time was significantly elevated in the third eccentricity group (P < .0038) and increased further toward the periphery (P < .00001). The results did not differ notably between retinitis pigmentosa subgroups.
Because the multifocal electroretinogram differentiates between affected and nonaffected retinal areas, eccentricity-dependent changes in both amplitude and implicit time were found. It can therefore add to the diagnostic information of many patients with retinitis pigmentosa.
在临床环境中研究多焦视网膜电图对色素性视网膜炎所致视网膜病变的诊断潜力。
在这项前瞻性研究中，对38例符合以下纳入标准之一的患者和30名正常志愿者进行了多焦视网膜电图检查：可检测到明视全视野反应或视野为10度或更大。使用视觉诱发电位成像系统进行记录，在30度视野内采用61个六边形单元的分辨率。通过曼-惠特尼U检验对每位患者和对照者左眼的结果进行统计学评估。
38例符合条件的患者包括患有I型和II型Usher综合征的患者（分别为1例和6例），以及患有常染色体隐性（18例）、X连锁隐性（2例）和常染色体显性（11例）色素性视网膜炎的患者。在这38例患者中的27例（71%）中，至少可检测到多焦视网膜电图的中央反应。色素性视网膜炎患者多焦视网膜电图反应密度在所有五个偏心度组（同心环）中均显著降低（P <.00001），且从中心向周边逐渐进展。在第三个偏心度组中，隐含时间显著延长（P <.0038），并向周边进一步增加（P <.00001）。色素性视网膜炎亚组之间的结果无明显差异。
由于多焦视网膜电图能够区分受影响和未受影响的视网膜区域，发现了振幅和隐含时间与偏心度相关的变化。因此，它可以为许多色素性视网膜炎患者增加诊断信息。
