无黄斑水肿的NPDR患者中心凹区mfERG与视网膜厚度的研究

Investigation of mfERG and retinal thickness in fovea of NPDR without macular edema

目的:分析非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)无黄斑水肿的患者黄斑中心凹区视网膜功能及厚度间的关系。方法:选取NPDR患者20例35眼患眼为糖尿病视网膜病变(diabetic retinopathy,DR)组,行多焦视网膜电图(multifocal electronic retinography,mfERG)及Spectralis相干断层扫描(Spectralis optical coherence tomography,Spectralis OCT)检查。以15例20眼正常眼为OCT对照组,以19例20眼正常眼为mfERG对照组,OCT对照组做Spectralis OCT检查,mfERG对照组做mfERG检查。结果:与对照组相比,DR组黄斑中心凹mfERGi环的P1波反应密度减小,P1波及N1波隐含期改变无统计学意义;DR组无水肿的黄斑中心凹视网膜厚度、神经上皮层厚度仍有显著增加。结论:应用mfERG可以在视网膜无可见明显结构改变之前发现视网膜功能上的异常变化;Spectralis OCT可以测量视网膜各层厚度,反映视网膜精细结构变化,验证视网膜功能上的异常改变,二者联合应用为极早期发现糖尿病视网膜病变视功能改变提供有效的证据,并为及时治疗提供资料。

AIM： To analyze the relationship between retinal function and retinal thickness in fovea in the patients of nonproliferative diabetic retinopathy （ NPDR ） without macular edema. METHODS：Multifocal electronic retinography （ mfERG） and Spectralis optical coherence tomography （ Spectralis OCT） examination were performed in 35 eyes of 20 NPDR patients without macular edema. Twenty eyes of 19 normal subjects underwent the mfERG and 15 eyes of 10 normal subjects underwent Spectralis OCT. RESULTS： Compared with normal group, the response densities P1 wave in Ring1 decreased and the change of latency of P1 wave and N1 wave had no statistical significance （ P〈0.05 ）. The retinal and neurosensory retinal thickness in fovea were thicker than normal. CONCLUSION：The application of mfERG can detect the abnormal changes in retina without obvious structural changes, Spectralis OCT can measure the thickness of retinal layers, reflect the changes of retinal fine structure, and identify the abnormal changes of retinal structure. The associated examination of these two instruments offered available evidences in detecting visual function change in early DR, and offer information for therapy in time.