糖尿病视网膜病变临床前期的视功能变化分析

Analysis of changes in visual function for clinical early diabetic retinopathy

目的:观察糖尿病视网膜病变临床前期患者的图形视觉诱发电位、视网膜振荡电位以及视神经纤维层厚度的变化,评估糖尿病视网膜病变临床前期视功能的变化。方法:收集糖尿病视网膜病变临床前期的2型糖尿病患者89例,以及健康志愿者80例。均采用罗兰电生理检查系统检测图形诱发电位(P-VEP)的P100潜伏期和振幅、视网膜振荡电位(Ops)总振幅和各子波振幅,以及RTVue OCT检测视神经纤维层厚度(RNFL),对检测结果进行比较分析。结果:糖尿病组患者的P100潜伏期比正常对照组的P100潜伏期明显延长,差异有统计学意义(t=-10.633,P=0.000)。糖尿病组患者的P100振幅比正常对照组的P100振幅明显降低,差异具有统计学意义(t=3.610,P=0.000)。糖尿病组患者OPS总振幅及各子波振幅均比正常对照组OPS总振幅及各子波振幅明显降低,差异具有统计学意义(t=17.320,P=0.000;t=3.239,P=0.000;t=4.144,P=0.000;t=7.666,P=0.000;t=5.319,P=0.000)。与正常对照组相比,糖尿病组患者的平均RNFL厚度及鼻侧、下方及颞侧RNFL厚度均无明显改变,差异无统计学意义(t=1.730,P=0.085;t=0.664,P=0.547;t=1.923,P=0.063;t=1.814,P=0.072)。而上方RNFL厚度明显变薄,与正常对照组相比差异显著(t=7.989,P=0.000)。结论:在糖尿病视网膜病变临床前期的患者,视乳头及黄斑区均出现了视功能改变。

AIM： To evaluate the changes in visual function of pattern visual evoked potentials, retina oscillatory potentials and optical nerve fibre layer thickness （RNFL） in diabetic retinopathy patients in preclinical stage. METHODS： In this stuy, 89 diabetic retinopathy patients in preclinical stage and 80 normal subjects were collected. The latency and amplitude of the pattern visual evoked potentials （P-VEP） P100, the summed amplitudes of the oscillatory potentials （Ops）, the amplitudes of the suboseillatory potentials, and RNFL thickness by RTVue OCT were observed, and the results were analyzed. = RESULTS： The latency of the pattern visual evoked potentials P100 in diabetic patients group was statistically delayed than that in normal group （ t= -10. 633, P= 0. 000）. The amplitude of the P-VEP P100 in diabetic patients group was also significantly reduced than that in normal group （t= 3. 610, P= 0. 000）. The summed amplitudes of the oscillatory potentials, the amplitudes of the suboseillatory potentials in diabetic patients group were significantly decreased by normal group （ t= 17.320, P= 0. 000;t=3.239, P=0.000; t=4.144, P=0.000; t=7.666, P=0. 000; t= 5. 319, P= 0.000）. Compared with normal group, the average RNFL thickness, the nosal quadrant, the inferior quadrant and the temporal quadrant of RNFL thickness in diabetic patients group were no statistiacally different from normal group （ t= 1. 730, P= 0.085 ; t= 0.664, P=0.547; t=1.923, P=0.063; t=1.814, P=0.072）, while the superior quadrant of RNFL thickness was significant thinner than that of normal group （t=7.989, P=0.000）. CONCLUSION： The visual function in optical nerve and macula decreases among diabetic retinopathy patients in preclinical stage.