| ObjectiveThe therapy of the vitreoretinal disease had been taken since 1900s. With the development of operation technology, the mission success rate of the operation had increased gradually. However, when it came to the results of the postoperative recovery of the visual function, there also left too much to hope. Fortunately, as an objective and sensitive method to testify the visual function, the visual electrophysiology, especially the skills of multifocal electrophysiology developed in recent years, had provided a new potential way to testify the visual function before and after the vitreoretinal surgery (VRS) objectively and efficiently. Always, the complicated retinal detachment (RD) was compared with the severe proliferative vitreoretinopathy (PVR) and dimmed as one of the severe diseases. In order to give a convenient criterion to select and improve the operation skills as well as provide a useful reference to prognosis, in this paper, multifocal electroretinalgram (mfERG) was taken to study the various function of the retina in different locations and the mechanism of the damage to the visual function of the complicated RD before and after VRS. MethodsThe mfERG of the affected eyes and the unaffected eyes of 80 complicated RD patients and 90 normal subjects were recorded by VERISE Science?4.2 multifocal visual evoked response imaging system. Based on the amplitudes and the latencies of the first order kernel of N1 and P1 waves, changes in different area including thedifferent eccentricities, central foveal, macular area and extra-macular area were investigated. By comparing the mfERG in different age levels in normal subjects, the influence of the age was shown. More over, we compared the mfERG of complicated RD before and after VRS, and explored the influence of vitreous hemorrhage, PVR, macular hole and traumatic history on mfERG. Following this were the studys of the influence of membrane peeling, perfluorocarbon liquid, silicon oil and complication such as intraocular pressure elevation, operative times and phacoscotasmus on mfERG and the relationship between vision and the mfERG. Finally, the stepwise regression was taken to analyze the factors that influence the mfERG after the VRS. Results1. The mfERG character of normal subjectsWhen analyzing the mfERG at different age levels, Nl and PI waves showed the highest amplitude in juvenile group and the longest latencies in middle and old age group. All the differences were statistically significant (P<0.05). With the increasing of the age, the amplitude became lower and the latencies longer. Also, the differences were meaningful (PO.05).2. The mfERG character of complicated RD(1) In all the unaffected and affected eyes of complicated RD group, the latencies of Nl wave and PI wave in the 6 rings were significantly delayed and their amplitudes markedly decreased compared with the normal group (PO.01).(2) The comparison of mfERG of complicated RD before and after VRS showed that the amplitude of PI and Nl waves increased in some degree after the operation. The differences in the second and third rings were statistically significant (PO.05). The latencies also shortened. The differences in the six rings were all statistically significant (PO.05). After analyzing the situations before and 1,3,6 months after the operation, it was shown that the amplitude of Nl and PI wavesincreased gradually and the latencies fell to the shortest point at the third month and then began to increase in the sixth month.(3) To that group which suffered serious vitreous hemorrhage before the operation, the Nl and PI waves showed lower amplitude in the first ring than those without. But the difference was not statistically significant (P>0.05). On the contrary, the amplitude turned to be higher in other rings and the differences were also meaningful (P<0.05). The difference of amplitude between two postoperative groups showed little statistically significant (P>0.05). Even if the amplitudes of Nl and PI waves included in the preoperative severe PVR group we... |
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