振荡电位和图形视网膜电图在亚临床期糖尿病视网膜病变诊断中的应用价值

The changes of OPs and P-ERG in sub-clinical stage of diabetic retinopathy

目的探讨视网膜电图振荡电位(OPs)和图形视网膜电图(P-ERG)在亚临床期糖尿病视网膜病变中的变化特点,并比较振荡电位和图形视网膜电图检测糖尿病患者视网膜功能异常的敏感性。方法选择确诊为Ⅱ型糖尿病,经检眼镜检查、眼底摄片检查,眼底无糖尿病视网膜病变的60例(120只眼)患者,进行振荡电位 (OPs)和图形视网膜电图(P-ERG)检查,观察亚临床期糖尿病视网膜病变的OPs总波幅及各子波波幅、潜伏期和 P-ERG的b波波幅、潜伏期的变化,并与正常组对照。结果在亚临床期糖尿病视网膜病变时,OPs总波幅及各子波波幅和P-ERG的b波波幅均降低,与正常对照组比较,差异均有显著性;但潜伏期在两组间无明显差异。亚临床期糖尿病视网膜病变组OPs总波幅和P-ERG的b波波幅的异常率分别为51．67％和36．67％,两者间差异有显著性。结论 OPs总波幅及各子波波幅和P-ERG的b波波幅在亚临床期糖尿病视网膜病变时即有改变,波幅的改变比潜伏期改变敏感;OPs检测方法较P-ERG敏感,提示OPs能更早、更准确地反映视网膜微循环机能的变化。因此OPs可作为诊断早期糖尿病视网膜病变较敏感的指标。

Objective To investigate the changes of oscillatory potentials （OPs） of electroretinogram （ERG） and pattern electroretinogram （P-ERG） in sub-clinical stage of diabetic retinopathy. Methods 60 patients （ 120 eyes） with I1 type DM without DR were detected by OPs and P-ERG. 30 cases （60 eyes ） of normal controls group had also been taken, to compare the difference of the amplitude and latency between two groups. Results The differences were significant in the amplitude of OPs and b-wave of P-ERG between two groups ; but the latency of OPs and P-ERG were no signifi cant difference. The positive rate of the amplitude of OPs（51.67% ） were significant higher than b-wave of P-ERG（36. 67% ）. Conclusion The amplitude of OPs and b-wave of P-ERG has changed in patient with sub-clinical stage of DR; The amplitude of OPs is more sensitive than b-wave of P-ERG.