重度非增生型糖尿病视网膜病变mfERG的定量分析

目的研究重度非增生型糖尿病视网膜病变（NPDR）多焦视网膜电图（mfERG）的特征及临床意义。方法30例（40眼）重度NPDR患者为NPDR组和35例（35眼）正常人为对照组。以国际分期作为NPDR诊断纳入标准,mfERG记录过程遵循国际临床视觉电生理学会的标准化方案,每个受试者在接受检查前均取得知情同意。结果与对照组相比,NPDR组患者mfERG2～5环的P1波、N1波反应密度明显下降,差异均有统计学意义（P〈0.05～0.01）;mfERG第Ⅱ象限和第Ⅲ象限的P1波、N1波反应密度明显降低,差异均有统计学意义（P〈0.05～0.01）。NPDR患者mfERG3～5环P1波、N1波隐含时较对照组明显延长,差异均有统计学意义（P〈0.05～0.01）;第Ⅰ象限和第Ⅲ象限隐含时显著延迟,差异均有统计学意义（P〈0.05～0.01）。结论NPDR可导致视网膜黄斑区视功能的损伤,mfERG能够客观、定量地反映黄斑区功能损害的程度。

Characteristics of mfERG in severe nonproliferative diabetic retinopathy

Background Clinically,the visual acuity of diabetic retinopathy（DR） is discrepant from the progression of disease.Nonproliferative diabetic retinopathy（NPDR） is the critical period of development of DR.Multifocal electroretinogram（mfERG） is a useful tool to detect the visual function.ObjectiveThe aim of this study is to investigate the characteristics of mfERG in patients with severe NPDR.MethodsForty eyes of 30 patients with severe NPDR and 35 normal eyes from matched 35 subjects were enrolled in this study.NPDR patients were diagnosed as the International Stages Standard for Diabetic Retinopathy.mfERG.was recorded upon the International Standard Protocol for mfERG.The oral informed consent was obtained from each individual prior to the trial.ResultsThe response densities of P1 and N1 of mfERG were attenuated from ring 2through ring 5 in NPDR patients compared with normal subjects（P0.05~0.01）,and those of quadrantⅡ and quadrant Ⅲ were significantly lower in the NPDR patients compared with normal subjects respectively（P0.05-0.01）.The latencies of P1 and N1 showed the significant prolong from ring 3 through ring 5 in NPDR patients compared with normal subjects（P0.05-0.01）,and those of quadrant Ⅲ and quadrant Ⅰpresented the considerablly delay in NPDR patients compared with normal subjects respectively（P0.05-0.01）.ConclusionThese results indicate that NPDR patients induce the damage of the visual function in retinal macular area.mfERG can objectively and quantitatively reflect the functional damage degree of macular area.