Layer-by-layer evaluation of function and morphology in macular diseases.

我们通过分析黄斑病变患者在黄斑手术前后的视网膜电图（ERG）和OCT（光学相干断层扫描）的各组成部分来研究黄斑病变的正常功能和形态。在糖尿病性黄斑水肿患者中，玻璃体切除术后，许多患者的OCT形态恢复良好，但只有少数患者的局灶性黄斑ERG恢复良好。结果提示，与黄斑形态的恢复相比，局灶性黄斑ERG显示的功能恢复可能明显延迟。在黄斑裂孔手术中，黄斑周围的内限制膜可被去除以放松视网膜，但对该手术的副作用知之甚少。我们比较了特发性黄斑孔患者去除内限定膜组（A组）和不去除内限定膜组（B组）。结果表明，功能技术（局灶性黄斑ERG）和形态技术（OCT）对黄斑病变的评价可以为黄斑手术前后的病理生理学提供有用的信息。

We investigated the vusual function and morphology by analysing each component of focal macular ERG (electroretinogram) and OCT (optical coherent tomography) in patients with variable macular diseases before and after macular surgery.In diabetic macula edema, many patients showed good recovery of morphology evaluated by OCT after vitrectomy, however, only limitted patients showed good recovery of focal macular ERG.This results suggest that the functional recovery shown by focal macular ERG may delay significantly as compared with the recovery of macular morphology.The inner limitting membrane around the macular area may be removed to relax the retina during macular hole surgery, however little is known about the side-effect of this procedure. We compared the group with removing the inner limitting membrane (Group A) and group without removing it (Group B) in idiopathic macular hole patients. We found that the recovery of ERG b-wave significantly delayed in Group A.Above results indicate that the evaluation of macular condition using functional techinique (focal macular ERG) and morphological technique (OCT) can provide useful informations in terms of the pathophysiology before and after macular surgery.