《视觉神经生理学》视网膜电图.ppt

* The term ‘pigmentosa’ refers to the pigmentary changes with a perivascular ‘bone-spicule’ configuration in the fundus of the eye (Figure 1). . * 谢谢大家！（Thank you！）下课！ 二、视网膜电图的临床应用 （一）原发性视网膜色素变性 （二）先天性静止性夜盲 先天性静止性夜盲CSNB 负型（Schubert-Bornschein型）：暗适应a波振幅正常，而b波振幅明显降低 Riggs型：暗视b波振幅超过a波，但a、b波振幅均低于正常 Oguchi病（小口病） 常染色体隐性遗传，明视ERG正常，暗视a、b波均消失 眼底白色斑点症 暗适应时间明显延长 （三）黄斑疾病 Stargardt disease 常隐，早期振幅正常，随着病变进展，明视振幅下降，病变累及周边者，明视、暗视均可异常 Best disease 常显，ERGa、b波振幅正常（鉴别） 确诊EOG ，光峰和暗谷比值异常 图形样营养不良 常显，ERG的振幅和峰时一般正常 视锥细胞营养不良 视锥细胞反应及30Hz闪烁光反应显示视锥细胞功能的显著下降是该病的典型特征 （四）遗传性玻璃体视网膜病变 （五）视网膜血管性疾病 视网膜血管阻塞 主要影响ERG振幅 CRAO CRVO 糖尿病性视网膜病变 b波振幅下降 OPs波峰时延长 振幅下降或消失 （六）其他 先天性静止性视锥细胞功能不良 视网膜脉络膜营养不良 视网膜脉络膜炎症 癌相关视网膜病变 视网膜脱离 视网膜中毒性疾病 …… Review Test 温故而知新 参 考 书 籍 主编：吴德正 , 刘妍 出版社：北京科学技术; 第1版 (2006年9月1日) 平装：205页 定价：150元 ISBN：7530433989 尺寸: 28.5 x 21 x 0.8 cm 视网膜色素变性 Multifocal electroretinogram. Severely attenuated paracentral responses in RP patient (left) in comparison to normal responses in a healthy subject (right). Fundus photograph of a patient with retinitis pigmentosa with the typical bone-spicule pigmentary changes (arrows). Left: photograph; right: fluorescein angiogram. Fundus photograph in patient with late-stage RP with the classic triad. Bone-spicule retinal pigmentation (black arrow), retinal vessel attenuation (white arrow) and waxy disc pallor (red arrow). Histological section through the human retina. Left: healthy retina; middle: retina of a patient with mid-stage RP; right: retina of a patient with late-stage RP. Goldmann visual fields of a RP patient demonstrating progressive concentric constriction. Top: mid-stage RP; bottom: late-stage RP. Scotopic electroretinography (ERG), ISCEV standard (International Society for Clinical Electrophysiology of Vision). Normal ERG responses in healthy subject (left) and extinguished responses in RP patient (right). Dark adaptation Dark adaptation of rods (green line) and cones (red line) in a healthy subject (top) and disturbed dark a