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Maintaining the homeostasis of intracellular components degradation and recycling, autophagy is a critical control mechanism of cellular quality. It promotes the degradation of cell components to provide nutrients and energy for cellular metabolism in stress response. The retina is a light-sensitive tissue that transduces and processes visual images in the eye, and it has a high demand for substances and energy. Basal autophagy is essential for holding retinal homeostasis and the normal function of the visual system. Therefore, the latest studies that investigating the participation of autophagy in eye diseases such as glaucoma, age-related macular degeneration, diabetic retinopathy, retinal dystrophies, and retinal detachment were summarized, providing a theoretical basis for the future treatment of eye diseases by regulating autophagy.
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Epiretinal membrane(ERM)is a retinal disease characterized by a fibrocell membranes that can develop on the inner surface of the retina. The existing clinical guidelines and literature have reached a consensus on the diagnosis and treatment of ERM, but the explanation of their mechanism is still controversial. Transforming growth factor-β(TGF-β)is a highly pleiotropic cytokine that plays an important role in wound healing, angiogenesis, immune regulation, cancer, inflammation and fibrosis diseases. Studies have increasingly shown that ERM is a kind of pathological changes in fibrosis that caused by the posterior vitreous detachment(PVD)and lead to the retinal inflammatory damage and epithelial to mesenchymal transition(EMT)of retinal pigment epithelial cells. A variety of cytokines regulate TGF-β-mediated EMT process by participating in the non-classical TGF-β-Snail pathway and the classical TGF-β-Smad pathway. At present, some drugs targeting cytokines related to the above pathway have entered the development stage, which is of great significance to provide new ideas for clinical treatment and prevention of ERM. This review reviews the progress of TGF-β related cytokines in ERM formation.
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@#Serpiginous choroiditis(SC)is a rare, chronic-idiopathic inflammatory disease mainly involving choriocapillaris and the retinal pigment epithelium(RPE), characterized by grayish yellow geographic lesions. Pathogenesis is unclear, the choriocapillaris is a main pathology of SC. Based on clinical presentation, it can be classified into peripapillary, macular, and ampiginoustype. The clinical appearance of SC is varied and similar to those of acute posterior multifocal placoid pigment epitheliopathy(APMPPE), tuberculosis, toxoplasmosis and choroidal ischemia. So, it is still difficult to diagnose SC without typical fundus symptoms.With the development of science and technology, multimode imaging such asfundus fluorescein angiography, indocyanine green angiography, fundus autofluorescence and optical coherence tomography are helpful for the diagnosis of SC, assessment of lesion extent, activity, and complications. Besides, it's very important to avoid unnecessary drug use.
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@#Familial exudative vitreoretinopathy(FEVR)is a rare inherited disorder of retinal angiogenesis. It is characterized by avascular peripheral retina. Mutations in FZD4, NDP, LRP5, TSPAN12, ZNF408, KIF11 have been found the causation genes of FEVR. The phenotypic features are variable, when some patients are asymptomatic while some may suffer from neovascularization, exudation, hemorrhage, retinal folds and retinal detachment. The use of FFA can help to identify the disease in the earlier stage, enabling timely treatment. The current treatments include laser photocoagulation, scleral buckling, vitrectomy and intravitreal anti-VEGF injections as an adjunctive therapy before surgery. With the development of genome research on this disease, the more effective diagnosis and treatments would be available.
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@#AIM: To evaluate the effectiveness of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane(ILM)flap technique for macular hole retinal detachment(MHRD)of high myopia. <p>METHODS: This was a retrospective case series. Totally 27 patients(27 eyes)who were diagnosised with MHRD of high myopia and underwent vitrectomy combined with inverted ILM flap covering technique were eIlrolled in this study. The diopter was ≥-6.00D and axial length was ≥26mm. The mean age was 53.69±7.23 years. And there 9 males and 18 females. The logarithm of the minimum angle of resolution(LogMAR)best-corrected visual acuity(BCVA)was 1.41±0.28. All patients were performed PPV with inverted ILM flap, resected the vitreous gel and cortex completely. Bright blue G stained the ILM around the fovea. The ILM was peeled off around the MH, and some portion of the ILM flap was left attached to the edge of the MH. Covering the MH with the ILM flap.Then, C<sub>3</sub>F<sub>8</sub> gas or silicone oil was injected into the vitreous cavity. The mean follow-up was more than 6mo and BCVA, MH closure, retinal reattachment, complications were retrospectively observed. <p>RESULTS: After surgery, visual acuity improved in 21 eyes(78%), unchanged in 4 eyes(15%), decreased in 2 eyes(7%). The mean LogMAR BCVA was 0.84±0.40, the difference was significant(<i>t</i>=7.32, <i>P</i><0.05). The macular hole closure rate was 89%(24 eyes)and retinal reattachment rate was 93%(25 eyes). No severe complicationwas observed. <p>CONCLUSION: PPV combined with inverted internal limiting membrane flap is an effective and safe management for the MHRD of high myopia.
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AIM:To observe the concentration of RBP4 and IL-6 in vitreous of proliferative diabetic retinopathy (PDR). METHODS: A total of 65 patients (66 eyes) were enrolled in Department of Ophthalmology, Renmin Hospital of Wuhan University from February 2017 to July 2017 with the informed consent. The patients were divided into PDR group (23 cases) and NPDR group (16 cases). Twenty- six patients without diabetic mellitus (DM) served as control group. The demography was matched among the groups, but the course of DM, the blood glucose level and the HbA1c level were elevated in the PDR group and the NPDR group (all P<0.05). Vitreous samples were collected during the procedure of vitrectomy. RBP4,IL-6,TNF-α concentrations in vitreous specimens were detected by ELISA. The differences of vitreous RBP4, IL-6 and TNF-α in various groups were statistically analyzed by ANOVA, respectively. The correlations between RBP4 and IL - 6, TNF - α were calculated by Pearson correlation analysis. RESULTS:The concentration of RBP4 in PDR group,the NPDR group and control group were 13.68士2.66, 11 03士1 12,10.45士1.17μ g/Ml, and the concentration of IL-6 were 56.0士10.27, 20.92士5.77, 10.26士1.91pg/Ml. RBP4 and IL- 6 concentrations were elevated in PDR group compared with NPDR group and control group, with significant difference among three groups (F = 12. 135, 161.167; P < 0. 01). IL - 6 concentrations in vitreous increased in the NPDR group in comparison with control group(P<0.05). RBP4 concentrations had no significant difference between the NPDR group and the group(P>0 05). Pearson correlation coefficient was significant positive between RBP4 concentration and IL - 6 concentration(r=0.606,P=0.001). CONCLUSION: RBP4 is probability involved in the inflammation pathogenesis of PDR. These results indicate that RBP4 could be a new target for the diagnosis and treatment of PDR.
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· AIM:To explore the modulation effects of 17-β estradiol (E2) and tamoxifen (TAM) in chronic intraocular hypertension mouse model.· METHODS:We performed anterior chamber injection of magnetic beads to induced chronic ocular hypertension models.Adult C57BL/6 male mice were used in the experiments and randomly divided into four groups:control,Beads group,E2 group and E2+TAM group.The intraocular pressure (lOP) were measured by Tonolab tonometer.Central retinal thickness was evaluated by HE staining.Brn3a as a specific marker of retinal ganglion cells (RGCs),were stained and counted by immunohistochemistry (IHC) staining.Glial fibrillary acidic protein (GFAP) as a marker of proliferation of astrocytes,was quantified using western blotting.· RESULTS:The IOP level was significantly elevated after anterior chamber injection of magnetic beads compared to control group (P<0.05),while in E2 and E2+TAM group,the IOP levels were reduced (P< 0.05 vs Beads group),especially in E2+TAM group in 2wk.The RGCs happened to degenerated in Beads group after 2wk,while the effects were reversed by E2+TAM (P<0.05).The central retinal thickness showed no significant statistical difference among the four groups after 2wk (P > 0.05).The expression level of GFAP increased caused via beads injection,however,decreased in E2 and E2+TAM group (P<0.05).· CONCLUSION:E2 and E2+TAM could both effectively decrease the IOP level in chronic intraocular hypertension mouse model,increase the survival of RGCs from high intraocular pressure,suppress expression of GFAP,which indicated neuroprotective effects of E2 and TAM in glaucoma through an anti-inflammatory effects.
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·AIM:To compare the effectiveness of inverted internal limiting membrane flap ( ILMF) coverage combined with sterile air tamponade or C3F8-filled surgery for idiopathic macular hole (IMH). ·METHODS: In this retrospective study, 165 patients (175 eyes) who underwent pars plana vitrectomy ( PPV) combined with inverted ILMF coverage were evaluated. The surgeries were performed by one surgeon at the Renmin Hospital, Wuhan University between January 2014 and June 2017. The patients were divided into sterile air (Group A) and C3F8-filled (Group B) groups, based on the technique used for intraocular tamponade. With a minimum 3-month follow-up, pre- and post-operative best corrected visual acuity ( BCVA ), macular hole closure rate, and major postoperative complications were analyzed. · RESULTS: Both groups showed significant improvement in visual acuity at 1 and 3mo postoperatively ( P< 0. 05 ). There was no significant difference between the two groups 1mo postoperatively, but the average BCVA in Group A was better than that in Group B at 3mo, to a level of statistical significance ( P<0. 05). The closure rate of macular hole was 97. 5% in Group A and 96. 8% in Group B, a statistically non-significant difference. There were no statistically significant differences in defect diameters of the inner and outer junctions between the two groups at 1 and 3mo postoperatively(P<0. 05), but significant differences compared to before surgery in both groups (P<0. 05). The rate of IOP elevation was 9. 5% in Group B, and zero ( 0 ) in Group A; this difference was statistically significant (P<0. 05). ·CONCLUSION: We postulate that PPV combined with inverted ILM flap is a safe and effective method for surgical management of IMH. Compared to C3F8-filling, sterile air tamponade can avoid IOP elevation; it may replace C3F8-filling in PPV for IMH.
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AIM: To investigate the time - effect relationship between the expression of rhodopsin and recoverin and photoreceptor damage induced by N - nethl - N -nitrosourea ( MNU) . METHODS: Thirty-six 7-week old Sprague-Dawley ( SD ) rats were intraperitoneally injected with MNU ( 60mg/kg ) and were put to death by dislocation of cervical vertebra 6, 12, 24h; 3, 7d after injection ( 6 per group) , respectively. As a control, six rats were injected with phosphate buffer saline (PBS) 5mL/kg and sacrificed on d3 after injection. The degree of photoreceptor apoptosis was detected by HE staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling ( TUNEL ) and transmission electron microscope ( TEM ) in the right eyes. The mRNA expressions of rhodopsin and recoverin were detected different time after injection by Western blot and immunohistochemical method in the left eyes. RESULTS:The dissolution of photoreceptor nucleus and apoptosis body were first perceived at 12h by TEM; most of cells at outer nuclear layer were presented positive reaction. The apoptotic index reached peak ( 29. 7% ±2.3%) at 24h which was coincided with the observation of TEM. The results of immunohistochemistry displayed that rhodopsin and recoverin were on a declining curve with time extension. Furthermore, the results of Western blot indicated that rhodopsin had dramatic decline at 6h after injection (P CONCLUSION:60mg/kg MNU intraperitoneally injection one - time may specifically induce photoreceptor apoptosis, The mechanism of down - regulation of rhodopsin and recoverin may be related to the selected apoptosis of photoreceptors.
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Background Previous studies showed that after herpes simplex virus-1 (HSV-1) infection of the cornea,matrix metallo proteinase-2 (MMP-2) (produced by corneal cells and corneal epithelial cells) plays an important role in the development of HSK.Focal adhesion kinase (FAK)plays an important role on the expression,release and activation of MMPs.This study explored the expressions of MMP-2 and FAK,which induced by HSV-1 infected human corneal epithelial cells.Objective To investigate MMP-2 and FAK expression in HSV-1 infected human corneal epithelial cells.Methods Human corneal epithelial cells were infected with HSV-1 in vitro to establish cell model of viral infection.The expression of MMP-2 and FAK were detected by reverse transcription PCR (RT-PCR),Western blot,immunohistochemical method and immunofluorescence method at 2 hours,20 hours and 40 hours after infection.Results At 2 hours,20 hours and 40 hours after infection,the expressionis of MMP-2 mRNA and FAK mRNA were significantly increased in comparison with uninfected cells (MMP-2 mRNA:Ftime =0.968,P=0.436 ; Fgroup =47.649,P =0.000 ; Fi ion =0.757,P =0.536.FAK mRNA:Ftime =0.658,P =0.631 ; Fgroup =35.182,P=0.000;Finteraction =1.386,P=0.137).Western blot assays showed that there were no significant differences in p-FAK,FAK or MMP-2 expressions between infected cells and control cells after 2 hours (P>0.05),but the expression levels of infected cells were significantly increased at 20 hours and 40 hours (both at P < 0.05).Immunohistochemistry results showed that longer infection time was associated with an increased number of cells staining for MMP-2,FAK and p-FAK.Conclusions At the initial stage of HSV-1 infected,p-FAK plays an important role in the process of virus invading and MMP-2 activation.
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BackgroundSweep pattern visual evoked potential(SPVEP) acuity,as an objective detective technique of visual function,can be used to measure visual acuity in children and uncooperative adults.Recent studies have shown that the amplitude-logarithm of the visual angle (A-LogVA) function regression method was more accurate than the amplitude-spatial frequency (A-SP)function regression method in evaluating SPVEP acuity.Objective This study was to explore the clinical use of SPVEP acuity in visual developing children and compare the evaluating the SPVEP acuity of children between A-SP function regression method and A-LogVA function regression method.Methods Twenty-six eyes of 26 asthenopic children with age range of 3-12 years and 31 age-matched normal children were enrolled in this study.SPVEP acuity was recorded with GT-2000 NV ( GUOTE MEDICAL APPARATUS LTD,China) using sinusoidally modulated horizontal gratings of 10 different spatial frequencies from 0.99 to 12.89 cpd as stimulus.The responses were averaged and displayed through discrete Fourier transformations (DFT) on the monitor display.SPVEP acuity was estimated by using both the SPVEP A-SP function regression method and the SPVEP A-LogVA function regression method.The LogMAR chart was used to acquire LogMAR visual acuity.ResultsIn the normal group,the correlation coefficient between LogMAR visual acuity and acuity calculated by the A-SP function regression method was 0.600 (P<0.01).The correlation coefficient between LogMAR visual acuity and acuity calculated by the A-LogVA function regression method was 0.733 ( P<0.01 ).The ANOVA of the LogMAR acuity and the SPVEP acuity calculated from the A-SP function regression method and A-LogVA function regression method were 113.173 (P<0.01 ),which indicated that there were significant difference among all of subjects.The differences of the mean values of LogMAR visual acuity and the SPVEP acuity calculated from the A-SP function regression method and A-LogVA function regression method were respectively 0.40±0.02,0.26 ±0.02 and 0.14 ± 0.02.In the amblyopia group,the correlation coefficient between LogMAR visual acuity and acuity calculated by the A-SP function regression method was 0.134 (P =0.515 ).The correlation coefficient between LogMAR visual acuity and acuity calculated by the A-LogVA function regression method was 0.456 ( P<0.05 ).The ANOVA of the LogMAR acuity and the SPVEP acuity calculated from the A-SP function regression method and A-LogVA function regression method were 3.433 (P<0.05),indicating that there were significant difference among all of subjects.The differences of the mean values of LogMAR visual acuity and the SPVEP acuity calculated from the A-SP function regression method and A-LogVA function regression method were 0.07±0.05,0.12±0.05 and 0.05 ±0.01 respectively.Conclusions SPVEP can evaluate the visual acuity in children,although SPVEP acuity may overestimate or underestimate acuity in comparison with different LogMAR visual acuities.The amplitude-LogVA function regression method is more accurate in extrapolating SPVEP acuity.
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BackgroundIt has been well-known that integrin linked kinase(ILK) plays an important role in the pathogenesis of neorascularization.But there are few researches to elucidate the relationship between ILK and retinal nevascularization. Objective This study was to explore the expression and significance of ILK on retinal neovascularization and new vessels regression in the oxygen-induced retinopathy(OIR) mouse model. Methods One hundred and twenty-eight 7-day-old C57BL/6J mice were randomly divided into the normal group and model group.The mice were rose in(75±2)%O2 environment with mother mice together for 5 days and then in normal environment for 5 days to establish the OIR models.The mice in normal group were rose in the normal environment for 21 days.The 17-day-old mice were sacrificed and retinal sections were prepared for histopathological examination and the numbers of the cellular nuclei of vascular endotheliumbreaking retinalinternal limiting membranewere calculated.Retinal sections and sheeting were prepared in 12,14,17 and 21 -day-old mice to examine the formation and regression of new blood vessel using ADP histochemistry staining,and then immunochemistry,real-time PCR and Western-blotting were used to detect the expressions of ILK and its mRNA in retina. ResultsThe numbers of the cellular nuclei of vascular endothelium breaking retinal internal limiting membrane were (45.64 ± 12.17 )in OIR group,and those of the normal group were( 0.35±0.14 )with a significant difference between two groups (t =22.85,P<0.05).Retinal new blood vessel appeared in 14-day mice,and peaked in 17-day mice and then regression in 21-day mice.ILK protein was expressed mainly in retinal ganglion cell layer,inner nuclear layer,inner plexiform layer and photoreceptor layer.Real-time PCR showed that ILK mRNA expressing levels in retina in model group were( 1.00±0.22),(1.85±0.17),(1.58±0.43) and(1.53±0.36) respectively in 12-,14-,17- and 21-day mice.Westernblotting determined that the A value of the ILK/β-actin was increased in 12-,14-,17-day mice and decreased in 21-day mice,and the A values were significantly higher in model group than the control group in various aged mice ( t =2.97,P<0.05 ;t =11.88,P<0.01 ;t =16.84,P<0.01 ;t =13.00,P<0.01 ). ConclusionsThese results indicate a space-time corresponding relation between the expression of ILK and retinal neovascularization.The obvious positive expression of ILK may be highly correlated with retinal neovascularization.
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Background Oxygen-induced retinal neovascularization is the main pathological basis for many retinal vascular diseases.Research showed that light exposure at night can suppress retinal neovascularization in oxygen-induced retinopathy(OIR),but there were few reports discussing its effect on ROP.Objective This study aimed to observe the effect of light exposure at night on retinal neovascularization in an OIR mouse model.Methods Sixty-four newborn C57 BL/6J mice were randomly divided into four groups,with 16 mice for each group.OIR models were established by rearing the newborn C57BL/6J mice with their mothers in a(75±2)% oxygen environment from postnatal day 7(P7)to Pl2,and then transferred to room air.In the OIR model group,the environmental illumination level was the same as the normal control group,and the model mice were exposed to 100 lx light at night in the OIR+ light exposure group.In the simple light exposure group,normal mice were reared in room air and were exposed to light at night from P12 to P17.All the mice were sacrificed on P17,and retinal flat mounts were prepared to assess the oxygen-induced changes of retinal vessels using the adenosine diphosphatase(ADPase)histochemical technique.The amount of proliferative neovascularization was quantified by counting the number of endotheliocyte nuclei in new vessels extending from the retinal inner limiting membrane into the vitreous in ocular cross-sections.The expression of the vascular endothelial growth factor(VEGF)protein was detected by immunohistochemistry.Real-time PCR analysis was performed to examine the expression of VEGF mRNA.The rearing and usage of the animals complied with the Statement of ARVO.Results Less free-vascular areas and new blood vessels were seen in the OIR+light exposure group compared with the OIR model group.On day 17 of the mouse life,the number of the endotheliocyte nuclei in new vessels extending from retinal inner limiting membrane were 0.97±0.83,1.00±0.72,38.57±5.01 and 16.92±3.39 in the normal group,simple light exposure group,OIR model group and OIR+light exposure group,respectively,showing significant differences among them(F =78.767,P =0.000).The number of nuclei in the OIR+light exposure group were less than that of the OIR model group(t=20.446,P<0.01).Immunochemistry showed that the expression of VEGF in retina was weaker in the OIR+light exposure group than the OIR model group.The relative expression values of VEGF mRNA were 1.00±0.00,0.94±0.07,2.08±0.50 and 1.43±0.21 in the normal group,simple light exposure group,OIR model group and OIR+light exposure group,respectively,showing a significant difference (F=11.268,P =0.003),where the VEGF mRNA level in the OIR+light exposure group was lower than that of the OIR model group(t =20.163,P<0.05).Conclusions Light exposure at night can weaken retinal neovascularization in OIR mice
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Background Sweep pattern visual evoked potential (SVEP) is an objective method of visual test.There is a clear correlation between SVEP acuity and subjective vision,but they are not identical.Recent studies showed that new regression method can improve the accuracy of SVEP acuity. Objective This trial was to investigate and compare the outcome between amplitude-spatial frequency (A-SP) regression method and amplitudelogVA (A-logVA) regression method in extrapolating the SVEP acuity.Methods SVEP was recorded in 113 eyes of 64 subjects using GT-2000 ( Guo Te,China) with the gratings of 10 different spatial frequency from 0.99 to 12.89 cpd as stimulus.The 1 13 eyes included cataract,glaucoma,corneal disease,optical neuropathy,retinal disease,ocular trauma,refractive error and normal eyes.The correlation were analyzed of SVEP acuity,decimal visual acuity and LogMAR visual acuity.The response were averaged and DFT on the monitor display.SVEP acuity was calculated by extrapolating 0 response amplitude.Results The correlation indices of decimal visual acuity curves obtained by the A-logVA function was 0.663,and that obtained by the A-SP function was 0.705.The positive correlation was seen between subjective decimal visual acuity and A-logVA decimal visual acuity (r =0.540,P< 0.01 ) and between subjective decimal acuity and decimal acuity calculated by the A-SP regression method (r=0.620,P<0.01 ).SVEP decimal acuity calculated by the A-SP function regression method was significantly different from the that calculated by the A-logVA function regression method (Z =-8.688,P<0.01 ).And the correlation indices of LogMAR visual acuity curves obtained by the A-logVA function was 0.733 and that obtained by the A-SP function was 0.715.The positive correlation was found between the subjective LogMAR acuity and that calculated by the A-SP regression method (r=0.700,P< 0.01 ) and between the subjective LogMAR acuity and LogMAR acuity calculated by the A-logVA regression method (r=0.710,P<0.01 ).SVEP LogMAR acuity from A-SP function regression method was significantly different from the LogMAR acuity from A-logVA function regression method (Z=-8.748,P<0.01 ).No significant differences of VA LogMAR were found in gender,eyes,type of disease and age(x2 =2.171,P=0.338;x2 =0.976,P=0.614;x2 =6.032,P=0.420;x2 =14.720,P=0.257 ).Conclusions SVEP can obtain the visual outcome in human.The amplitude-logVA function regression method is more accurate in extrapolating SVEP acuity.
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Background Fibrin glue has been utilized to adhere the graft during the pterygium excision with conjunctival autografts.Several relevant clinical randomized controlled trial(RCT) and retrospective studies have been published abroad,but the samples for its effectiveness and safety issue of fibrin glue and suture are still underinvestigation.Objective Current study was to quantificationally assess the efficacy and safety of fibrin glue versus sutures in the application of pterygium excision with conjunctival autografts.Methods Based on established search strategy,a computerized literature search was conducted to identify all citations concerning the RCT for effectiveness and safety evaluation of fibrin glue and suture for the graft fixation during the pterygium excision with conjunctival autografts from MEDLINE ( from 2000 to October,2010 ),EMbase ( from 2000 to October,2010 ),Cochrane Central Register of Controlled Trials ( Issue 4,2010 ),CBMdisc ( 2000 to October 2010 ),CNKI ( 2000 to October 2010 ),and the relevant conference proceedings and references searched by hand was performed as supplement.The included literature was scored with Jadad table.The Cochrane Collaboration' s RevMan 5.0 software was used for the test of heterogeneity or test for overall effect.The effective indexes,such as operative duration,recurrence rate and complication,were evaluated by Meta analysis.Results Six RCTs involving 401 eyes of 377 participants were identified.These literatures were published with English in 2004-2010 from China,New Zealand,Sweden,Israel,Turkey and Malasia and the Jadad scores were 4-5.The quantitatively analysis revealed that fibrin glue appeared to short the operative time compared with suturing method (MD =14.23 ;95% CI:- 16.18- 12.29;P=0.00) and drop the rate of recurrence ( RR =0.49,95% CI:0.26 -0.95 ; P =0.03 ).No significant differences were found in the rate of postoperative graft dehiscence or absence (RR =3.41,95 % CI:0.85-13.68;P =0.08 ).Conclusions Fibrin glue shows the good effectiveness and easy application during the pterygium excision with conjunctival autografts.Long-term follow-up of multi-central RCTs with a larger number of cases are still needed to support this conclusion.
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Objective To investigate the waveform of the first-order kernel and second-order kernel of muhifocal electroretinogram stimulated with light emitting diode(LED).Design Prospective,noncomparative,interventional case series.Participant 18 subjects(18 eyes)who had been accepted the mfERG test.Method The patients were devided into two groups,they accepted the muhifocal elec- troretinogram(mfERG)stimulated with cathode ray tube(CRT)and LED using the Roland RETI Scan3.15 system.The first-order kernel or the second-order kernel was analyzed.The stimulation time of LED were changed from 1.7ms to 16.7ms.Five different stimulation time of LED in this study were 1/10(1.7ms),3/10(5ms),5/10(8.3ms),7/10(ll.7ms)and 10/10(16.7ms).Main Outcome Measure The summed responses were observed.The waveform,amplitude and implicit times of mfERG summed response were analyzed.Result The waveforms of the first-order kernel stimulated by LED were similar to those of CRT.In the second-order kernels of mfERG,the wave- forms were obviously different from those stimulated by LED and CRT.The P1 wave stimulated by CRT was sharp,but the P1 wave of LED was broad.The N2 wave of LED was deeper.The amplitude of N1 wave and P1 wave were increased,and their implicit times pro- longed with the stimulation times prolonging.Conclusion In the first-order kernel of mfERG,the waveform of the summed response stimulated by LED was similar to that of LED.In the second-order kernel of mfERG,the waveform stimulated by LED was more com- plicated,may be there were more inner retina information.(Ophthalmol CHN,2006,15:351-355)