国际眼科纵览 ›› 2014, Vol. 38 ›› Issue (5): 309-315.doi: 10.3760/ cma. j. issn.1673-5803.2014.05.005

• 综述 • 上一篇    下一篇

视觉电生理检查在青光眼诊断中的应用

安晶  张作明   

  1. 710032 西安,第四军医大学航空航天医学系
  • 收稿日期:2014-02-18 出版日期:2014-10-22 发布日期:2014-10-24
  • 通讯作者: 张作明,Email:zhangzm@fmmu.edu.cn

Clinical application of visual electrophysiology technique in glaucoma

AN Jing, ZHANG Zuo-ming.   

  1. Department of Aerospace Clinical Medicine, Fourth Military Medical University, Xi'an 710032, China
  • Received:2014-02-18 Online:2014-10-22 Published:2014-10-24
  • Contact: ZHANG Zuo-ming, Email: zhangzm@fmmu.edu.cn

摘要: 视觉电生理技术中图形视网膜电图(pattern electroretinogram,PERG)、明视负波反应(photopic negative response,PhNR)、多焦点视网膜电图(multifocal electroretinogram,mfERG)、多焦点视觉诱发电位(multifocal visual evoked potential,mfVEP)以及暗适阈值反应(scotopic threshold response,STR)等检查方法,被应用于评价各阶段青光眼病程的变化,可为早期诊断提供帮助。PERG、PhNR能直接反映视网膜神经节细胞(retina ganglion cell,RGC)的功能以及视神经的功能状态。PERG指标最敏感,能在可疑青光眼时期反应发生变化;PhNR现阶段用于评价RGC的损伤程度;mfERG可评价RGC功能的空间分布,其二阶反应变化的空间分布与视野较相近;患者对mfVEP检查的配合度较标准视野检查的配合度好且客观,结果更敏感、特异;STR需要较苛刻的刺激条件,目前的研究结果表明STR对青光眼患者敏感性较差。(国际眼科纵览, 2014, 38: 309-315)

Abstract: The visual electrophysiological techniques, such as pattern electroretinogram (PERG), photopic negative response (PhNR), multifocal electroretinogram (mfERG) and multifocal visual evoked potential (mfVEP), scotopic threshold response (STR), were applied to evaluate changes in each stage of the course of glaucoma. And these methods could provide help for the early diagnosis of it. PERG, PhNR can directly reflect the function of retinal ganglion cells (RGC) and optic nerve. PERG is the most sensitive indicator, the response changes are detected in suspected glaucoma. Recently the evaluation of damage degree of RGC could be shown by PhNR. Secondorder kernel mfERG be used to evaluate the spatial distribution of RGC function, the response is similar to the result of visual field. MfVEP is a sensitive index for patients with visual field loss. STR requires rigorous stimulation conditions; the current results show that the STR is not a sensitive index to glaucoma patients compared with other visual electrophysiological techniques.  (Int Rev Ophthalmol, 2014, 38:   309-315)