摘要目的 观察累及黄斑的孔源性视网膜脱离(RRD)患眼手术前后黄斑区多焦视网膜电图(mfERG)及中心视野变化.方法 回顾性研究.累及黄斑的RRD患者16例16只眼(RRD组)及年龄与之匹配的正常者20名20只眼(正常对照组)纳入研究.RRD组患眼均行巩膜扣带手术治疗.手术前及手术后1、3、6个月,行mfERG及中心视野检查,观察RRD组及正常对照组受检眼的黄斑区反应波振幅密度和潜伏期,以及4°视野平均敏感度(MS).分析RRD组患眼黄斑区反应波振幅密度、潜伏期与MS的相关性以及正常对照组、RRD组mfERG与视野检查的一致性.结果 与正常对照组比较,手术前RRD组患眼黄斑区反应波N1、P1波振幅密度降低、潜伏期延长,差异均有统计学意义(P＜0.05).手术后1、3、6个月RRD组患眼与手术前比较,患眼黄斑区反应波N1、P1波振幅密度明显提高、潜伏期缩短,差异均有统计学意义(P＜0.05).与正常对照组比较,RRD组患眼手术后1、3、6个月黄斑区反应波N1、P1波振幅密度降低、潜伏期延长,差异均有统计学意义(P＜0.05).手术前RRD组患眼4°视野MS值较正常对照组明显降低,差异有统计学意义(t=49.752,P＜0.05).RRD组患眼手术后1、3、6个月4°视野MS值较手术前提高,差异均有统计学意义(t=-9.580、-16.533、-19.580,P＜0.05);但均低于正常对照组,差异也有统计学意义(t=-6.286、-7.493、-6.366,P＜0.05).相关性分析结果显示,手术后1、3、6个月,RRD组患眼黄斑区反应波振幅密度与MS呈正相关(P＜0.05),潜伏期与MS无相关性(P＜0.05).正常对照组、RRD组mfERG与视野检查一致性较好(K=0.886,P＜0.05).结论 累及黄斑的RRD患眼与正常对照眼mfERG、中心视野比较,手术前后黄斑区反应波N1、P1波振幅密度降低、潜伏期延长,MS值降低;与手术前mfERG、中心视野比较,手术后黄斑区反应波N1、P1波振幅密度明显提高、潜伏期缩短,MS值提高.

abstractsObjective To observe the changes of multifocal electroretinogram(mfERG)and central visual field before and after surgery in patients with rhegmatogenous retinal detachment (RRD) involving the macular area.Methods This is a retrospective study.Sixteen patients (16 eyes) with RRD involving the macular area (RRD group) and age-matched normal 20 cases (20 eyes,normal control group) were enrolled in the study.All patients in RRD group underwent scleral buckling surgery.Before surgery and 1,3,6 months after surgery,RRD eyes and normal eyes were checked by using mfERG and central visual field examination,and macular reaction wave amplitude density,incubation period and 4° visual field mean sensitivity (MS) were observed.The correlation between amplitude density,incubation period and MS in RRD group and the consistency between mfERG and central visual field examination in normal control group and RRD group were analyzed.Results Compared with the normal control group,in RRD group before surgery the macular reaction wave N1 and P1 amplitude density reduced,the incubation period prolonged,the differences were statistically significant (P＜ 0.05).Postoperative 1,3,6 months,in RRD group macular reaction wave amplitude density improved,the incubation period reduced than before surgery,the differences were statistically significant (P＜0.05).Postoperative 1,3,6 months,in RRD group macular reaction wave amplitude density reduced,the incubation period prolonged compared with the normal control group,the differences were statistically significant (P＜0.05).Compared with the normal control group,4° visual field MS significantly reduced in RRD group before surgery reduced,the differences were statistically significant (t=49.752,P＜0.05).Postoperative 1,3,6 months,4° visual field MS significantly increased compared with the preoperative value,the differences were statistically significant (t=-9.580,-16.533,-19.580; P＜ 0.05); but were lower than that of the normal control group,the differences were statistically significant (t =-6.286,-7.493,-6.366 ; P＜0.05).Postoperative 1,3,6 months,macular reaction wave amplitude density and MS in RRD group showed positive correlation (P＜0.05),and there was no correlation between incubation period and MS (P＞0.05).mfERG and vision consistency in normal control group and RRD group showed good agreement(K =0.886,P＜0.05).Conclusions Compared with normal control eyes,in RRD eyes involving the macula area before and after surgery,macular reaction wave amplitude density reduced,the incubation period prolonged and MS values reduced; compared with the preoperative mfERG and central visual field,macular reaction wave amplitude density improved,the incubation period reduced and MS values increased.