多焦视网膜电图对单纯型糖尿病视网膜病变的评估分析

Evaluation and Analysis of Multifocal Electroretinogram for Simple Diabetic Retinopathy

目的运用多焦视网膜电流图(multifocal electroretinogram,mfERG)评估单纯型糖尿病视网膜病变(diabetic retinopathy,DR)患者各分期相应的视网膜功能的变化情况,以更及时地发现早期的DR,控制DR患者的病情发展。方法回顾性分析2015年5月—2016年7月来该院就诊的29例(56眼)单纯型DR患者的临床资料,经眼底血管荧光造影分期,把患眼分为Ⅰ期DR 21眼、Ⅱ期DR 16眼、Ⅲ期DR 19眼;同期选取健康人10名(20眼),纳入正常对照组。采用由德国Roland公司生产的RETIscan多焦视觉电生理仪,记录正常人20眼及单纯型DR 56眼的mfERG P1波的反应振幅密度和P1波、N1波潜伏期在各环的表现。结果随着糖尿病视网膜病变病情的进展,mfERG P1波的反应振幅密度呈现下降的趋势,P1波、N1波的潜伏期呈现出延长的趋势,差异有统计学意义(P<0.05)。结论P1波反应的振幅密度是DR的敏感指数,mfERG能判断病变的位置,范围及严重程度,对评估不同时期DR的视网膜功能有着重要作用。

Objective Multifocal electroretinogram(mfERG)was used to evaluate the changes of retinal function in each stage of patients with simple diabetic retinopathy(DR),so as to detect early DR in a more timely manner and control the disease development of DR patients.Methods The clinical data of 29 patients(56 eyes)with simple DR who came to the hospital from May 2015 to July 2016 were retrospectively analyzed.According to the staging of fundus fluorescein angiography,the affected eyes were divided into 21 eyes of stageⅠDR,16 eyes of stageⅡDR,and 19 eyes of stageⅢDR.During the same period,10 healthy people(20 eyes)were selected and included in the normal control group.The RETIscan multifocal visual electrophysiology instrument produced by Roland Company in Germany was used to record the response amplitude density of mfERG P1 waveform and the performance of P1 waveform and N1 waveform latency in each ring of 20 normal eyes and simple DR56 eyes.Results With the progression of diabetic retinopathy,the response amplitude density of mfERG P1 wave showed a downward trend,and the latency of P1 wave and N1 wave showed a prolonged trend,and the difference was statistically significant(P<0.05).Conclusion P1 waveform and N1 waveform amplitude density are the sensitivity index of DR,mfERG can determine the location,extent and severity of lesions,and plays an important role in evaluating the retinal function of DR in different periods.