光学相干断层扫描与视觉电生理检查分析糖尿病黄斑水肿患者黄斑部形态学及视功能改变

Correlation between macular morphology and visual function change in patients with diabetic macular edema detected by optical coherence tomography and visual electrophysiology

目的利用光学相干断层扫描(OCT)与视觉电生理检测,分析糖尿病黄斑水肿(DME)患者黄斑部形态学及视功能改变的关系,为临床治疗提供相关依据。方法选取2014年12月至2016年12月在武汉市普仁医院确诊为糖尿病黄斑水肿的患者190例(320眼)为观察组,同时选取无黄斑水肿及视网膜病变的同期糖尿病患者180例(301眼)为对照组。检测患者的最佳矫正视力,并对患者进行光学相干断层扫描及视觉电生理检查。结果观察组190例患者(320眼)最佳矫正视力为0.02~0.6,对照组180例患者(301眼)最佳矫正视力为0.7~1.5,差异具有统计学意义(P<0.05);观察组的黄斑中心凹视网膜神经上皮层平均厚度为(330.17±87.3)μm,比对照组的(150.39±22.9)μm增加了98%,差异有统计学意义(P<0.05)。结论发生黄斑水肿及视网膜病变的糖尿病患者与未发生黄斑水肿及视网膜病变的糖尿病患者,在黄斑形态学及视功能改变方面差异显著,光学相干断层扫描与视觉电生理对临床检查具有重要的作用。

Objective To analyze the correlation between macular morphology and visual function change by optical coherence tomography and visual electrophysiological examination so as to provide the basis for the clinical treatment of diabetic macular edema. Methods The 190 patients（320 eyes） with diabetic macular edema from December2014 to December 2016 in Wuhan Puren Hospital were selected as the observation group. 180 diabetic patients without macular edema and retinopathy（301 eyes） were selected as the control group. The best corrected visual acuity were detected, and optimum coherence tomography and visual electrophysiological examination were performed on the patients with diabetic macular edema. Results The best corrected visual acuity in the 190 patients（320 eyes）in the observation group was 0.02~0.6 and the best corrected visual acuity in the 180 diabetic patients（301 eyes） of the control group was0.7~1.5, which showed the significant difference between the two groups（P〈0.05）. The average thickness of retinal neuroepithelium layer at the fovea in 190 patients in the observation group（330.17±87.3） μm increased by 98% compared with that in the control group（150.39 ± 22.9） μm（P〈0.05）.Conclusion There were significant differences in macular morphology and visual function between the diabetic patients with macular edema and retinopathy and those without macular edema and diabetic retinopathy. Optical coherence tomography and visual electrophysiology play an important role in clinical examination.