早期糖尿病视网膜病变的多焦视网膜电图改变的研究

摘要

Objective To investigate the changes of multifocal electroretinogram (mf-ERG) in early diabetic retinopathy (DR). Methods The first order kernel (FOK) of the mf-ERG was performed in 29 diabetic patients with normal retinal thickness and corrected visual acuity of 1. 0 or more. The presence or absence of non-proliferative diabetic retinopathy (NPDR) was identified by the fundus fluorescein angiography (FFA). Fifteen age-matched healthy subjects were selected as the control group. Results Compared with the control subjects, the FOK amplitudes of N1, P1, and N2 in the NDR group were significantly decreased, and the latency of N1, P1, and N2 were not statistically delayed; while the FOK amplitudes of N1 and N2 in the NPDR group were significantly decreased, and the latency of N1 and P1 were delayed. Compared with the NDR group, the FOK amplitudes of N1 and P1 in Ring 1~6 and P1 in Ring 1~ 2 and 4 — 5 in the NPDR group were significantly decreased, and the latency of N1 and P1 were not statistically delayed. Conclusion Changes of mf-ERG in early diabetic retinopathy develop before the presence of diabetic retinopathy morphological changes.%目的 观察早期DR在多焦视网膜电图(mf-ERG)一阶Kernel反应的改变. 方法 筛选29例(58眼)视力正常、视网膜厚度正常、无糖尿病视网膜病变(NDR)或轻、中度非增殖期糖尿病视网膜病变(NPDR)的T2DM患者,行mf-ERG一阶Kernel反应检查.将29例T2DM患者分为NDR组和NPDR组,另选年龄匹配的15名健康者作为正常对照(NC)组. 结果 与NC组相比,NDR组N1、P1、N2波反应密度明显降低,潜伏期则差异无统计学意义；NPDR组N1、N2波反应密度明显降低,N1波、P1波潜伏期延长.与NDR组相比,NPDR组的N1波、P1波反应密度在环1～6、P1波在环1～2及环4～5明显降低,而潜伏期则差异无统计学意义. 结论 T2DM患者未出现形态学上的视网膜病变前,多焦视网膜电图已经发生改变.