调制传递函数联合视觉电生理对糖尿病视网膜病变早期诊断的意义

The significance of electrophysiological tests combined with modulation transfer function on the early diagnosis of diabetic retinopathy

目的探讨调制传递函数（MTF）联合视觉电生理对糖尿病视网膜病变（DR）早期诊断的意义。方法横断面研究。通过对48例（80眼）无视网膜病变的糖尿病（NLDR）患者、52例（80眼）非增殖性DR（NPDR）患者和40例（80眼）正常对照者行MTF、闪光视网膜电网（ERG）、图形视诱发电位（PVEP）检查，NLDR和NPDR的三项测量结果与正常对照组的比较采用独立样本t检验。结果相对正常对照者，NLDR和NPDR患者的MTF在中高频区均表现出幅值降低（P〈0．05）；NLDR患者和NPDR患者，ERGOp2波表现为振幅下降和潜伏期延长（P〈0．05）；NPDR患者PVEPP100波表现为振幅下降和潜伏期延长（P〈0．05），但NLDR患者相比正常对照者PVEPP100波差异无统计学意义。NLDR患者采用MTF和ERGOp2波联合检测阳性率高达76％，NPDR患者采用两者联合检测阳性率高达90％，明显高于两者分别检测所得到的阳性率。结论MTF和ERGOp2联合检测．可早期发现DR的视网膜功能性损害。是一种可行的敏感性较高的检测手段。

Objective To evaluate the importance of modulation transfer function （MTF） and visual electrophysiology in the early onset of diabetic retinopathy （DR）. Methods It was a cross-sectional study. A total of 240 eyes were studied, including 48 no lesions diabetic retinopathy （NLDR） patients （80 eyes）, 52 non-proliferative DR patients （NPDR） （80 eyes） and 40 normal controls （80 eyes）. The MTF, electroretinogram （ERG） and pattern visual evoked potential （PVEP） were measured. Data were analyzed with an independent samples t test. Results For high frequencies, MTF of NLDR and NPDR patients showed a significant reduction （P〈0.05）, the ERG Op2 of the NLDR and NPDR patients showed a decline in amplitude and an extended incubation period （P〈0.05）, the PVEP P100 for the non-proliferative DR patients showed a decrease in amplitude and an extended incubation period （P〈0.05）, but there was no significant difference in the DR patients. The positive rate of combined testing of MTF and ERG Op2 for NLDK patients was 76% and it was 90% for NPDR patients. Conclusion The combined applications of MTF and ERG Op2 has a high sensitivity, which is important for the early detection of retinal damage.