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:目的 :通过对视网膜脱离 (retinaldetachment ,RD)眼的局部视网膜电图 (localelectroretinogram ,LERG)记录分析 ,进一步了解RD眼黄斑部光感受器细胞与第二级神经元功能异常的情况 ,并对LERG与视功能预后的关系进行探讨。方法 :12 0例RD患者 12 8只眼的LERG被记录分析 ,应用手提眼底镜式局部刺激器通过放大的瞳孔直视眼底监控固视状况 ,记录a波、b波与OPs各项成分。结果 :与对照组相比 ,LERG的a波、b波与OPs的异常率 :在 <1周组分别为 15 %、15 %与 10 % ;在1～ 2周组为 35 %、45 %与 5 0 % ;在 2～ 4周组为 46 86 %、5 6 2 5 %与 6 2 5 % ;在 4～ 8周组为 76 %、84%与 88% ;在 8周以上组则为 86 96 %、91 30 %与 95 5 6 %。a波与b波在脱离时间 <1周组与对照组无明显差异 ;1～ 2周组a波与b波开始有明显降低 (P <0 0 5 ) ,随着发病时间的延迟 ,b波的下降较a波更为迅速 ,在 2～ 4周则具有高度显著意义 (P <0 0 1) ;b/a值在早期RP病变表现正常或轻度异常 ,伴随病程增加有降低趋势 ,在 4～ 8周组即出现显著性降低 (P <0 0 5 )。在眼底镜下黄斑部脱离的 48只眼中 ,LERG各项成分的降低均有统计学意义 ;而在眼底镜下观测不到黄斑脱离的 80只眼中 ,b波、OPs与OP2子波振幅也表现异常 (P <0 0 5 )。结论
: Objective: To further understand the dysfunction of macular photoreceptor cells and secondary neurons in RD eye by recording and analyzing the local electroretinogram (LERG) of retinal detachment (RD) Visual function prognosis of the relationship. Methods: LERG of 128 eyes of 120 patients with RD were recorded and analyzed. The conditions of fixation were monitored by magnifying pupillary fundus and the contents of a wave, b wave and OPs were recorded with hand - held endoscope type local stimulator. Results: The abnormal rates of a, b and OPs of LERG were 15%, 15% and 10% respectively in LERG group compared with 35% and 45% in 1 ~ 2 weeks group 5 0%; 46 86%, 56 52% and 62 5% in 2 to 4 weeks; 76%, 84% and 88% in 4 to 8 weeks and 86% 96%, 91 30% and 95 5 6%. There was no significant difference between a wave and b wave at <1 week from the control group, while a wave and b wave decreased significantly at 1 ~ 2 weeks (P <0 05). With the delay of onset, b wave (P <0.01). The b / a value showed normal or mild abnormality in early stage of RP, and decreased with the increase of course of disease 4 to 8 weeks group that was significantly reduced (P <0 05). In the 48 eyes with macular detachment under funduscopy, the reduction of LERG components was statistically significant. In the 80 eyes with no macular detachment, the amplitude of b wave, OPs and OP2 wavelets also showed Abnormal (P <0 05). in conclusion