作者：卢光，夏群，李永，高岩 作者单位：100730）中国北京市，卫生部北京医院眼科
【摘要】 目的：探讨对比敏感度对特发性黄斑视网膜前膜（idiopathic macular epiretinal membranes，IMEM）的视功能评价。
【关键词】 特发性黄斑视网膜前膜;对比敏感度
Contrast sensitivity of patients with idiopathic macular epiretinal membranes Guang Lu, Qun Xia, Yong Li, Yan Gao Department of Ophthalmology, Beijing Hospital of Ministry of Public Health, Beijing 100730, China Abstract
AIM: To evaluate the contrast sensitivity of idiopathic macular epiretinal membranes(IMEM).
METHODS: Ninetysix eyes of 71 patients with IMEM were examined with conventional visual acuity. The contrast sensitivity of both healthy eye and diseased eye were checked by FACT. All data were analyzed by SPSS 11.0. RESULTS: The visual acuity of diseased eye were 0.151.2, and that of healthy eye were 0.251.5. The mean LogMAR visual acuity of diseased eye was 0.15±0.21, which was lower than that of the healthy eye (0.03±0.09). The difference was significant(P＜0.01). The contrast sensitivity showed that the mean contrast sensitivity were significantly lower than that of the healthy eye in different frequency zones（P＜0.01）. The difference of contrast sensitivity was influenced by the difference of visual acuity. Even some of the diseased eye had the same visual acuity with the healthy eye, and the contrast sensitivity was different. And the difference was mainly showed in the high frequency zone.
CONCLUSION: IMEM can cause not only the vision decline but also the contrast sensitivity decline. And the contrast sensitivity is more important and sensitive to monitor the visual function.
KEYWORDS: idiopathic macular epiretinal membranes; contrast sensitivity方法：常规检测71例患者96只视网膜前膜（IMEM）患眼的视力，采用对比敏感度检测卡（FACT）检测患眼和健眼的对比敏感度。采用SPSS 11.0软件统计分析资料。
结果：患眼的视力为0.15～1.2，健眼视力为0.25～1.5。采用最小角度对数视力统计患眼的平均LogMAR视力为（0.15±0.21），较健眼的平均LogMAR视力（0.03±0.09）低，差异有显著性（P＜0.01)。对比敏感度检查显示IMEM患眼各频区的平均对比度值较健眼显著低下（P＜0.01)。视力的良莠直接影响到对比度值的高低，并且部分IMEM患眼视力虽然与健眼相等，甚至达到1.0，但其对比敏感度值却已显示出了差异。主要表现在高频区的损害。
结论：特发性黄斑视网膜前膜的视功能损害不仅会有视力下降，还会出现对比敏感度值下降。对比敏感度检查是反映视功能的重要、敏感指标之一。0引言
特发性黄斑视网膜前膜（idiopathic macular epiretinal membranes，IMEM）是临床常见的眼底黄斑病变。其临床发病隐匿，进展缓慢，轻者因对视功能无影响而不被查觉，病情加重时出现视力下降，视物变形等症状。我们检测了96只IMEM患眼的对比敏感度功能，现报道如下。
1对象和方法
1.1对象 2002/2007年间对来自于我院眼科门诊和体检人员中的IMEM患者，排除患有其他影响视力的眼病之后，选择了其中71例IMEM患者作为检查对象。其中男35例，女36例。年龄51～85（平均69.4±7.7）岁。单眼患者46例（64.8%），双眼25例（35.2%），合计96眼。单眼双眼之比约2∶1。
1.2方法 采用标准对数视力表检查视力，在AR7100P自动验光仪电脑验光基础上主觉插片法获得最佳矫正视力；散瞳下用直接或间接检眼镜及90.00D前置镜加裂隙灯下检查眼底。全部患者行光相干断层扫描（OCT）、荧光素眼底血管造影（FFA）等辅助检查。对比敏感度检查矫正46cm近视力，采用美国Stereo Optied公司FACT对比敏感度测试卡。在标准照明下，由左向右顺序检测IMEM眼和非IMEM眼的各频区对比敏感度识辨能力。
统计学分析：采用SPSS11.0统计软件。计数资料采用卡方检验；计量资料采用t检验；视力采用最小角度对数视力（LogMAR）统计比较IMEM患眼与非IMEM眼视力。对比敏感度值采用均数（）及标准差（s）比较IMEM患眼与非IMEM眼的对比度值。
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