糖尿病视网膜病变mf-ERG一阶Kernel反应不同分析方法研究

Observe the changes of FOK of mf-ERG using different analytical methods in diabetic retinopathy

目的观察不同方法分析糖尿病视网膜病变（DR）的多焦视网膜电图（mfERG）一阶kernel反应（FOK）的变化特征，探讨预测早期DR视功能受损的敏感电生理指标。方法横断面研究。于2012年1月至5月在中山大学附属孙逸仙纪念医院糖尿病住院患者46例，其中16例无糖尿病视网膜病变（no DR）、15例轻度非增殖性糖尿病视网膜病变（mild NPDR）和15例中度非增殖性糖尿病视网膜病变（moderate NPDR），正常对照组16例FOK反应，任选左右眼，进行多焦视觉电生理检查系统分析，采用不同分析方法比较不同病变程度DR的N1、P1波潜伏期、振幅密度差异。结果随着DR病变严重程度加重，九分法发现N1、P1波潜伏期渐延长；四分法发现N1、P1波潜伏期渐延长，N1振幅密度依次降低；六分法仅发现N1潜伏期的异常。结论FOK的N1、P1波的潜伏期可能是较振幅密度更为敏感视网膜功能异常的观察指标，且其潜伏期的延长与DR的严重程度呈正比关系。统计分析DR的mfERG一阶反应时，以象限为单位优于按离心度的环形区域划分。

Objective To investigate the changes of the first order kernel （FOK） of Multifocal electroretinogram （mf-ERG） in diabetic retinopathy using different analyses. Methods Forty-six con- secutive cases of diabetes mellitus were collected from January 2012 to May 2012 in Sun Yat-sen memorial hospital. The FOK of mf-ERG was performed in 16 no diabetic retinopathy （no DR）, 15 mild non-proliferative diabetic retinopathy （mild NPDR） and 15 moderate NPDR; 15 age-matched healthy subjects were selected as the control group. Results With the increasing the retinopathy se- verity, N1 and P1 implicit times gradually delayed using nine analyses; N1 and P1 implicit times gradually delayed and NI amplitude decreased using four analyses; N1 implicit times gradually de- layed using six analyses. Conclusions Compared to amplitude, implicit time of FOK has greater sen- sitivity to abnormal retinal function. There is a significant correlation between retinopathy severity and the magnitude of the delays of N1 and P1 implicit times. Using quadrant prior to centrifuge analyses the FOK of mf-ERG in DR is better.