Weiner A, Schmidt M E, Patel S, Gussler C H, Remler B F, Kaufman S R, Kohn H D, Weidenthal D T
Division of Ophthalmology, Saint Luke's Medical Center, Cleveland, Ohio 44104, USA.
Arch Ophthalmol. 1998 Sep;116(9):1161-8. doi: 10.1001/archopht.116.9.1161.
To determine whether foveal outer retinal dysfunction is common in eyes with unexplained visual symptoms or acuity loss.
Prospective study.
Seventy-three eyes of 44 consecutive patients with unexplained visual symptoms or acuity loss, 39 eyes of 39 control subjects, and 12 eyes of 7 patients with known maculopathy.
Foveal cone electroretinography (ERG) and letter recognition perimetry.
Foveal cone ERG data.
Abnormal foveal cone ERG data were recorded in 35 (48%) of 73 eyes (23 [52%] of 44 patients). Among these 35 eyes, amplitude was lower than in normal controls (P<.001) and was correlated with visual acuity and the number of letter recognition perimetry errors (P<.05 for both). The latter was higher in eyes with abnormal retinal responses than in symptomatic eyes with normal responses (P<.01). However, initial symptoms, visual acuity, and macular appearance did not differentiate between these 2 groups. Foveal cone ERG test vs retest data showed consistent results.
Foveal outer retinal dysfunction is a common underlying mechanism of previously unexplained visual symptoms or acuity loss. Foveal cone ERG testing should be considered early in the evaluation of eyes with this presentation.
确定在有无法解释的视觉症状或视力下降的眼中，黄斑中心凹外视网膜功能障碍是否常见。
前瞻性研究。
44例连续患有无法解释的视觉症状或视力下降的患者的73只眼，39名对照受试者的39只眼，以及7例已知黄斑病变患者的12只眼。
黄斑中心凹视锥细胞视网膜电图（ERG）和字母识别视野检查。
黄斑中心凹视锥细胞ERG数据。
73只眼中有35只（48%）（44例患者中的23例[52%]）记录到异常的黄斑中心凹视锥细胞ERG数据。在这35只眼中，振幅低于正常对照组（P<0.001），并且与视力和字母识别视野检查错误数量相关（两者均P<0.05）。视网膜反应异常的眼中字母识别视野检查错误数量高于视网膜反应正常的有症状眼（P<0.01）。然而，初始症状、视力和黄斑外观在这两组之间并无差异。黄斑中心凹视锥细胞ERG测试与复测数据显示结果一致。
黄斑中心凹外视网膜功能障碍是先前无法解释的视觉症状或视力下降的常见潜在机制。对于有此表现的眼睛，在评估早期应考虑进行黄斑中心凹视锥细胞ERG测试。
