眼底未见改变的糖尿病患者微视野光敏度值分析

Analysis of microperimeter in diabetic patients without retinopathy

目的探索研究在未见眼底改变糖尿病患者使用微视野检查，以期发现无眼底改变的糖尿病患者微视野光敏度值变化的规律。方法糖尿病病程5年以上，扩瞳检查眼底未见病变，屈光度范围：球镜度数-3．00D至±2．00D，散光〈1．00D，最佳矫正视力／〉4．9患者61例105只眼，年龄16～66岁，平均年龄（54．51±7．96）岁。应用MP-1微视野计（MP-1NidekTechnologies，Vigonza，Italy）检查。观察指标：黄斑20度视网膜区域内中心2度环及其以内、4度环、6度环、8度环、10度环平均视网膜光敏度值；研究分析各环微视野视网膜光敏度差异；以及探索无眼底改变糖尿病患者视网膜光敏度值与最佳矫正视力的关系并分析是否存在相关性。统计采用SPSSl9．0软件，统计方法：单因素ANOVA分析、相关分析及一元线性回归。结果无眼底改变糖尿病患者微视野光敏度中心2度环及其以内、4度环、6度环、8度环、10度环视网膜光敏度分别为（15．16±1．31）dB、（17．43±1．43）dB、（17．29~1．63）dB、（17．46±1．59）dB、（16．81±1．85）dB，单因素ANOVA分析，2度环及其以内、10度环视网膜光敏度下降明显（F=39．795，P=0．000）。中心2度环及其以内视网膜光敏度值与最佳矫正视力散点图显示存在正性线性相关趋势，行相关分析显示相关系数为0．817，两变量有相关性，P=0．000，回归分析显示R。=0．667。回归方程：Y=0．04376X±4．5323，用方差分析对包含常数项的回归方程做显著性检验，F=206．43，P=0．000。结论糖尿病病程5年以上，无眼底改变情况下，其黄斑20度微视野光敏度值在中心2度环及其以内、10度环视网膜光敏度下降明显。微视野检查丰富了糖尿病患者在无眼底改变时期的视功能检测的手段。

Objective Diabetic retinopathy （DR）, a vascular disorder affecting the microvascula- ture of the retina, is associated with degeneration of neurons, especially those located in the inner retina. To evaluate the effect of MP-1 microperimeter in detecting the early retinal abnormalities in diabetic patients and to provide evidences and ways for the prevention and cure of diabetic retinopa- thy, using the microperimeter （MP-1） in diabetic patients without retinopathy.Methods 61 diabetic patients without retinopathy（total 105 eyes） were evaluated.MP-1 microperimeter was used to quanti- fy the retinal sensitivity. We performed complete ophthalmic examinations, including best-corrected vi- sual acuity, slit-lamp examination, indirect ophthalmoscopy, OCT,FFA, and microperimetry （central 20° of macula） on 105eyes of 61 participants.All statistical analysis including One-way ANOVA,cor- relation analysis and linear regession were calculate with SPSS 19.0.Results The mean age of partici- pants was （mean± SD） （54.51±7.96）years for participants with diabetes but no retinopathy. There was significant loss of retinal sensitivity in 2°retina and 4°retina in participants with diabetes but no retinopathy, P 〈0.05. （ One-way ANOVA）. The mean retinal sensitivity in 2°retina were positively correlated with the Best-corrected visual acuity.The correlation analysis showed a correlation coefficient of 0.817, P 〈0.01, R2=0.667, and regression formula coule been delivered as Y=0.04376X± 4.5323（F =206.43,P =0.000）.Conclusion The early changes of retinal function in patients with diabe- tes but no retinopathy can be detected and quantitatively by the MP-I microperimeter even before the appearance of diabetic retinopathy.Using the MP-1 microperimeter,we can detect early loss of ret- inal sensitivity in patients with diabetes but no retinopathy. MP-1 is a sensitive method which can provide evidences and ways for the prevention and cure of diabetic retinopathy.