糖尿病性黄斑水肿激光治疗前后视网膜功能的定量研究

Quantitive study for retinal function before and after photocoaguiation in patients with diabetic macuiar edema

目的:探讨激光光凝对糖尿病黄斑水肿患者视网膜功能的影响。方法:连续选取2010-03/2014-03我院眼科经眼底血管造影检查确诊为糖尿病性黄斑水肿行黄斑格栅光凝的患者19例30眼,于治疗前及黄斑格栅光凝治疗后3mo均行多焦视网膜电图检查,并对其结果进行统计学分析。结果:激光治疗后中心凹处a、b波振幅密度升高,与治疗前相比存在统计学差异(t=-3.7683,P<0.01;t=-3.6570,P<0.0 1);激光治疗前后a、b波潜伏期无统计学差异(t=1.7103,P>0.05;t=1.5623,P>0.05)。激光治疗后黄斑区a、b波振幅密度均升高,与治疗前相比存在统计学差异(t=4.8337,P<0.01;t=-2.0376,P<0.05);激光治疗后黄斑区a、b波潜伏期均延长,与治疗前相比均存在统计学差异(t=-2.1892,P<0.05;t=-3.5024,P<0.01)。激光治疗前后黄斑外区a、b波振幅密度均无统计学差异(t=-1.4387,P>0.05;t=-0.1766,P>0.05);激光治疗后黄斑外区a、b波潜伏期均延长,与治疗前相比均存在统计学差异(t=-2.0905,P<0.05;t=-2.5646,P<0.05)。结论:激光光凝治疗改善了中心凹处视网膜的功能,有益于视力的改善,但激光光凝治疗糖尿病性黄斑水肿对黄斑区和黄斑外区视网膜的功能有广泛的破坏作用。

AIM：To study the retinal function in patients with diabetic macular edema after photocoagulation.METHODS：A total of 30 eyes in 19 patients with diabetic macular edema（DME）,who were diagnosed through fundus fluorescein angiography,consecutively recruited from March 2010 to March 2014 and were treated with macular grid pattern photocoagulation.Multifocal electroretinogram（mfERG） system（version 3.15） was performed before and after photocoagulation therapy for3 mo.All data were statistically analyzed.RESULTS：The amplitude densities of a-ware and b-ware for the fovea increased after macular grid pattern photocoagulation therapy,and there were significantly changes relative to its preoperation（t=-3.7683,P0.01;t=-3.6570,P0.01）.No remarkable changes in the latency of a-ware and b-ware of fovea were measured before and after photocoagulation（t=1.7103,P0.05;t=1.5623,P0.05）.Compared with pretreatment,the amplitude densities of aware and b-ware at macular were statistically larger（t =4.8337,P0.01;t=-2.0376,P0.05）.The latency of a-wave and b-wave at macular was significant longer after treatment（t =-2.1892,P0.05;t =-3.5024,P0.01）.There were no significant differences in the amplitude densities of a-ware and b-ware at paramacular after therapy（t=-1.4387,P0.05;t=-0.1766,P0.05）.It was significant longer in the latency of a-wave and b-wave at paramacular after photocoagulation（t=-2.0905,P0.05;t=-2.5616,P0.05）.CONCLUSION：The laser photocoagulation treatment for DME can improve the retinal function at fovea,which benefits the vision acuity.Unfortunately,it induces extensively damaging effects on the macula and paramacular.