中心性浆液性脉络膜视网膜病变患者的多焦视网膜电图改变以及与视力和黄斑区视网膜下液厚度的相关性

发布时间：2018-11-24 13:02

【摘要】：目的:探讨中心性浆液性脉络膜视网膜病变患者的多焦视网膜电图改变以及与视力和黄斑区视网膜下液厚度三者之间的相关性。方法:收集45例单眼中心性浆液性脉络膜视网膜病变患者,年龄在20~58岁,男性36例,女性9例;记录患者最佳矫正视力(log MAR记录方式表示)、黄斑区视网膜厚度和黄斑区视网膜下液厚度;通过RETIScan多焦视觉电生理检查系统(德国ROLAND公司)对所有患者进行检查,选取一阶函数核的各项检测值。设立正常对照组共20例(40只眼),年龄在23~53岁,男性14例,女性6例,均接受与实验组相同的检查并记录数据。分析比较两组数据。结果:实验组最佳矫正视力的平均值为(0.46±0.17)LogMAR。正常组黄斑区平均视网膜厚度为(222.3±9.17)μm,范围为205~241μm;实验组黄斑区平均视网膜厚度为(484.36±105.34)μm,范围为289~682μm,黄斑区视网膜下液平均厚度为(328.09±108.18)μm,范围为96~532μm;实验组黄斑区平均视网膜厚度与正常组之间差异显著(t=16.547,P0.05)。实验组1环P1波及N1波振幅、1~2环P1波及1环N1波振幅密度与正常组相比均有显著降低(P0.05),1~2环P1波潜伏期与正常组相比明显延长(P0.05),余无统计学差异。通过分析相关性可知,实验组最佳矫正视力(log MAR)与黄斑区平均视网膜厚度、黄斑区视网膜下液平均厚度之间呈正相关关系;最佳矫正视力(logMAR)与1环N1波振幅、振幅密度之间呈显著负相关,与1环P1波潜伏期间呈显著正相关;黄斑区平均视网膜厚度、黄斑区视网膜下液平均厚度与1环P1波、N1波潜伏期呈正相关,余无相关性。结论:中心性浆液性脉络膜视网膜病变患者的黄斑区平均视网膜厚度与正常人相比有显著差异,黄斑区视网膜厚度及视网膜下的积液量与黄斑区功能变化密切相关。与正常人相比,中心性浆液性脉络膜视网膜病变患者的多焦视网膜电图改变明显;其改变与视力、黄斑区平均视网膜厚度及黄斑区视网膜下液平均厚度之间存在相关。临床上将视力、光学相干断层扫描和多焦视网膜电图相结合可更客观准确地对中心性浆液性脉络膜视网膜病变患者的视网膜形态和功能进行综合评价,有利于中心性浆液性脉络膜视网膜病变的诊疗及随访。
[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 卤0. 17) LogMAR.. The mean retinal thickness in the normal group was (222.3 卤9.17) 渭 m, and the range was 205 ~ (241) 渭 m. The mean retinal thickness of the experimental group was (484.36 卤105.34) 渭 m, and the mean thickness of the subretinal fluid in the macular area was (328.09 卤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.
【学位授予单位】：川北医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R774.1

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