光学相干断层扫描与视觉电生理检查在年龄相关性黄斑变性中的观察研究

发布时间：2018-07-16 16:09

【摘要】：目的:探讨光学相干断层扫描(Optical Coherence Tomography,OCT)及视觉电生理(visual electrophysiological examination)对年龄相关性黄斑变性(age-related macular degeneration,ARMD)黄斑部形态学改变、视功能改变的相关性。方法:随机选择初次诊断为年龄相关性黄斑变性患者萎缩型26例(31眼)、渗出型27例(30眼)以及同年龄段正常眼对照21例(30眼),进行最佳矫正视力的测定、黄斑中心凹的OCT检查及视觉电生理检查,眼电生理检查包括视网膜电图(electroretinogram , ERG)和图形视觉诱发电位(pattern visual evoked potentia1,P-VEP)检查。结果:①黄斑中心凹视网膜神经上皮层厚度:萎缩组(184.5±27.1μm)与正常对照组(195.4±21.9μm)比较差异无统计学意义(P 0.05),渗出组(272.9±39.6μm)与正常对照组(195.4±21.9μm)比较差异有显著性(P0.01)。②最佳矫正视力:萎缩组和渗出组中心最佳矫正视力均较正常组明显下降,差异有统计学意义(P0.01)。渗出组较萎缩组中心最佳矫正视力下降更严重,差异有统计学意义(P0.01)。③暗适应ERG:与正常组对比,萎缩组b波潜伏期延长(P0.01),a、b波振幅下降(P0.01)。而渗出组a、b波潜伏期延长及振幅下降(P0.01)。与萎缩组对比,渗出组b波振幅下降(P0.05),a、b波潜伏期延长(P0.01)。④P-VEP:与正常组对比,萎缩组P100波潜伏期延长(P0.05),振幅下降(P0.01)。渗出组P100波潜伏期延长(P0.01),振幅下降(P0.01)。与萎缩组对比,渗出组P100波潜伏期延长(P0.01),振幅下降(P0.01)。结论:年龄相关性黄斑变性的患者,渗出型的眼底形态学改变及视功能改变均较萎缩型严重。对于早期黄斑变性的患眼,眼电生理的变化早于OCT变化。对于临床上怀疑年龄相关性黄斑变性,但不适宜做眼底荧光血管造影的患者,采取光学相干断层扫描联合视觉电生理检查有助于早期发现和确诊年龄相关性黄斑变性。
[Abstract]:Objective: to investigate the correlation between optical coherence tomography (Oct) and visual electrophysiological (visual electrophysiological examination) on macular morphology and visual function in age-related macular degeneration. Methods: 26 cases (31 eyes) of atrophic type, 27 cases (30 eyes) of exudative type and 21 cases (30 eyes) of normal eyes were randomly selected to determine the best corrected visual acuity (BCVA). Oct and visual electrophysiological examination of macular fovea included electroretinogram (electroretinogram,) and pattern visual evoked potential (pattern visual evoked potentia1P VEP). Results there was no significant difference in retinal neuroepithelial layer thickness between atrophy group (184.5 卤27.1 渭 m) and normal control group (195.4 卤21.9 渭 m). There was significant difference between exudation group (272.9 卤39.6 渭 m) and normal control group (195.4 卤21.9 渭 m) (P0.01). The central best corrected visual acuity of atrophy group and exudative group were significantly lower than that of normal group. The difference was statistically significant (P0.01). The decrease of BCVA in exudation group was more serious than that in atrophy group, the difference was statistically significant (P0.01) .3 dark adaptation ERG: compared with normal group, the latency of b wave prolonged (P0.01) in atrophy group (P0.01) and the amplitude of B wave decreased (P0.01). In the exudation group, the latency and amplitude of AGB wave were prolonged and decreased (P0.01). Compared with the atrophic group, the amplitude of b wave in the exudation group was decreased (P0.05), the latency of B wave was prolonged (P0.01). 4 P-VEP: compared with the normal group, the latency of P100 wave in the atrophic group was prolonged (P0.05) and the amplitude decreased (P0.01). In the exudation group, the latency of P 100 wave was prolonged (P 0.01) and the amplitude was decreased (P 0.01). Compared with the atrophy group, the latency of P 100 wave in exudation group was prolonged (P 0.01) and the amplitude was decreased (P 0.01). Conclusion: the fundus morphology and visual function of patients with age-related macular degeneration are more serious than those of atrophic type. The change of eye electrophysiology was earlier than that of Oct for the eyes with early macular degeneration. For patients with age related macular degeneration suspected clinically, but not suitable for fundus fluorescein angiography, optical coherence tomography combined with visual electrophysiological examination is helpful for early detection and diagnosis of age related macular degeneration.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R774.5

【相似文献】