發(fā)布時(shí)間：2018-11-24 13:02

【摘要】：目的:探討中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者的多焦視網(wǎng)膜電圖改變以及與視力和黃斑區(qū)視網(wǎng)膜下液厚度三者之間的相關(guān)性。方法:收集45例單眼中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者,年齡在20~58歲,男性36例,女性9例;記錄患者最佳矯正視力(log MAR記錄方式表示)、黃斑區(qū)視網(wǎng)膜厚度和黃斑區(qū)視網(wǎng)膜下液厚度;通過RETIScan多焦視覺電生理檢查系統(tǒng)(德國(guó)ROLAND公司)對(duì)所有患者進(jìn)行檢查,選取一階函數(shù)核的各項(xiàng)檢測(cè)值。設(shè)立正常對(duì)照組共20例(40只眼),年齡在23~53歲,男性14例,女性6例,均接受與實(shí)驗(yàn)組相同的檢查并記錄數(shù)據(jù)。分析比較兩組數(shù)據(jù)。結(jié)果:實(shí)驗(yàn)組最佳矯正視力的平均值為(0.46±0.17)LogMAR。正常組黃斑區(qū)平均視網(wǎng)膜厚度為(222.3±9.17)μm,范圍為205~241μm;實(shí)驗(yàn)組黃斑區(qū)平均視網(wǎng)膜厚度為(484.36±105.34)μm,范圍為289~682μm,黃斑區(qū)視網(wǎng)膜下液平均厚度為(328.09±108.18)μm,范圍為96~532μm;實(shí)驗(yàn)組黃斑區(qū)平均視網(wǎng)膜厚度與正常組之間差異顯著(t=16.547,P0.05)。實(shí)驗(yàn)組1環(huán)P1波及N1波振幅、1~2環(huán)P1波及1環(huán)N1波振幅密度與正常組相比均有顯著降低(P0.05),1~2環(huán)P1波潛伏期與正常組相比明顯延長(zhǎng)(P0.05),余無(wú)統(tǒng)計(jì)學(xué)差異。通過分析相關(guān)性可知,實(shí)驗(yàn)組最佳矯正視力(log MAR)與黃斑區(qū)平均視網(wǎng)膜厚度、黃斑區(qū)視網(wǎng)膜下液平均厚度之間呈正相關(guān)關(guān)系;最佳矯正視力(logMAR)與1環(huán)N1波振幅、振幅密度之間呈顯著負(fù)相關(guān),與1環(huán)P1波潛伏期間呈顯著正相關(guān);黃斑區(qū)平均視網(wǎng)膜厚度、黃斑區(qū)視網(wǎng)膜下液平均厚度與1環(huán)P1波、N1波潛伏期呈正相關(guān),余無(wú)相關(guān)性。結(jié)論:中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者的黃斑區(qū)平均視網(wǎng)膜厚度與正常人相比有顯著差異,黃斑區(qū)視網(wǎng)膜厚度及視網(wǎng)膜下的積液量與黃斑區(qū)功能變化密切相關(guān)。與正常人相比,中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者的多焦視網(wǎng)膜電圖改變明顯;其改變與視力、黃斑區(qū)平均視網(wǎng)膜厚度及黃斑區(qū)視網(wǎng)膜下液平均厚度之間存在相關(guān)。臨床上將視力、光學(xué)相干斷層掃描和多焦視網(wǎng)膜電圖相結(jié)合可更客觀準(zhǔn)確地對(duì)中心性漿液性脈絡(luò)膜視網(wǎng)膜病變患者的視網(wǎng)膜形態(tài)和功能進(jìn)行綜合評(píng)價(jià),有利于中心性漿液性脈絡(luò)膜視網(wǎng)膜病變的診療及隨訪。
[Abstract]:Objective: to investigate the changes of multifocal electroretinogram in patients with central serous chorioretinopathy and their correlation with visual acuity and the thickness of subretinal fluid in macular area. Methods: 45 patients with monocular central serous chorioretinopathy, aged 2058 years, 36 males and 9 females, were collected. The best corrected visual acuity (log MAR), macular retinal thickness and macular subretinal fluid thickness were recorded. All patients were examined by RETIScan multifocal visual electrophysiological examination system (ROLAND, Germany), and the detection values of first-order function kernel were selected. There were 20 cases (40 eyes) of normal control group, aged 23 to 53 years, 14 males and 6 females. All of them received the same examination as the experimental group and recorded the data. Two groups of data were analyzed and compared. Results: the mean value of the best corrected visual acuity in the experimental group was (0. 46 鹵0. 17) LogMAR.. The mean retinal thickness in the normal group was (222.3 鹵9.17) 渭 m, and the range was 205 ~ (241) 渭 m. The mean retinal thickness of the experimental group was (484.36 鹵105.34) 渭 m, and the mean thickness of the subretinal fluid in the macular area was (328.09 鹵108.18) 渭 m. The mean retinal thickness in the experimental group was significantly different from that in the normal group (t = 16.547, P 0.05). The amplitudes of P1 wave and N1 wave in the experimental group, P1 wave and N1 wave in the 1st ring and the 1st ring in the experimental group were significantly lower than those in the normal group (P0.05), and the latency of P1 wave in the 1st ring and the 2nd ring in the experimental group were significantly longer than those in the normal group (P0.05), but there was no statistical difference in the rest. Through the analysis of the correlation, the best corrected visual acuity (log MAR) in the experimental group was positively correlated with the mean retinal thickness in the macular area and the mean thickness of the subretinal fluid in the macular area. The best corrected visual acuity (BCVA) was negatively correlated with amplitude and density of N1 wave in ring 1 and positively correlated with latency of P1 wave in ring 1. The mean retinal thickness in macular area and the mean thickness of subretinal fluid in macular area were positively correlated with the latency of P1 wave and N1 wave, but there was no correlation between them. Conclusion: the mean retinal thickness of macular area in patients with central serous chorioretinopathy is significantly different from that in normal subjects. The retinal thickness of macular area and the amount of subretinal effusion are closely related to the functional changes of macular area in patients with central serous chorioretinopathy. Compared with normal subjects, the changes of multifocal electroretinogram in patients with central serous chorioretinopathy were significant, and the changes were correlated with visual acuity, mean retinal thickness of macular area and mean thickness of subretinal fluid in macular area. The combination of visual acuity, optical coherence tomography and multifocal electroretinogram can evaluate the retinal morphology and function of patients with central serous chorioretinopathy more objectively and accurately. It is beneficial to the diagnosis and treatment of central serous chorioretinopathy.
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R774.1

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