糖尿病视网膜病变黄斑区视网膜厚度与多焦视网膜电图变化的关系

Relationship between the thickness of macula and the changes of multifocal electroretinograms in diabetic retinopathy

目的 了解糖尿病视网膜病变 (diabetic retinopathy,DR)患者黄斑区视网膜厚度以及相对应的视网膜功能改变。方法 对 38例患者 6 0只 DR ～ 期患眼进行光学相干断层扫描 (optical coherencetomography,OCT)及多焦视网膜电图 (multifocal electroretinography,m ERG)的检查。数据应用 SPSS统计软件进行处理 ,并作线性相关分析。 结果 黄斑中央 5°区域 N1 、P1 和 N2 波反应密度绝对值与黄斑中心凹神经上皮层厚度呈显著的负相关 (γ=- 0 .2 5 2～ - 0 .2 6 6 ,P<0 .0 5 ) ;黄斑中央 10°区域 N2 波反应密度绝对值与黄斑中心凹神经上皮层厚度呈显著的负相关 (γ=- 0 .332 ,P=0 .0 1)。黄斑中央 5°和 10°区域 N1波潜伏期与黄斑中心凹视网膜厚度无显著的相关关系 ,而黄斑中央 5°区域 P1 和 N2 波潜伏期与黄斑中心凹视网膜色素上皮厚度有显著的负相关 (γ=- 0 .2 71～ - 0 .32 2 ,P<0 .0 5 )。 结论 DR患者黄斑区神经上皮厚度的改变影响黄斑区局部视网膜的功能状态 ,主要表现为黄斑中央 5°和 10°区域 m ERG各波反应密度的降低。

Purpose To investigate the relationship between the changes of the thickness of retina in macula and the abnormalities in multifocal electroretinograms (mERG) in diabetic retinopathy. Methods mERG and optical coherence tomography (OCT) examination were performed in 38 patients (60 eyes) with DR (phase Ⅲ～Ⅳ). The data were processed with software SPSS and line relation analysis was done. Results The response densities of N 1, P 1 and N 2 in central 5° area was significantly negative related to the thickness of neuroretina in macular fovea (correlation efficient -0.252～-0.266, P< 0 05). The response density of N 2 in central 10° area was also significantly negative related to the thickness of neuroretina in macular fovea (correlation efficient -0.332, P =0.01).There was no significant relationship between the latencies of N 1 in central 5°, 10° area and the thickness of macula, whereares the latencies of P 1 and N 2 in central 5° were negatively related to the thickness of retinal pigment epithelium in the macular fovea (correlation efficient-0.271～-0.322, P< 0.05). Conclusion The changes of the thickness of neuroretina in macula may affect the local retinal function in macula, which may be revealed by the reduction of response densities in mERG in patients with diabetic retinopathy.