多焦视网膜电图在亚临床期糖尿病视网膜病变中的变化

目的:探讨多焦视网膜电图(multifocal electroretinogram,mf-ERG)的一阶(first order kernel,FOK)和二阶(second order kernel,SOK)反应在亚临床期糖尿病视网膜病变的变化.方法:回顾性分析,选取2014-06/2015-05确诊为2型糖尿病,但眼底无糖尿病视网膜病变患者32例58眼作为糖尿病组,进行多焦视网膜电图一阶反应、二阶反应检查,并与同期门诊检查的正常组对照.结果:与正常对照组相比,糖尿病组FOK总和反应b波潜伏期无明显延迟,而b波的振幅降低,差异有统计学意义(t=3.099,P=0.012).糖尿病组SOK总和反应b波的峰时延迟,差异有统计学意义(t=2.643,P=0.025),且b波的振幅降低,差异有统计学意义(t=4.833,P<0.01).糖尿病组a波在FOK和SOK中的振幅和潜伏期变化差异均无统计学意义.将b波振幅、潜伏期分别与糖尿病病程行相关性分析,结果显示b波振幅与病程呈负相关,而b波潜伏期与病程无相关性.结论:在亚临床期糖尿病视网膜病变中FOK、SOK均有变化,主要反映在b波的振幅变化.

Changes of multifocal electroretinogram in subclinical diabetic retinopathy

AIM: To investigate the changes of first order kernel(FOK)and second order kernel(SOK)of multifocal electroretinogram(mf-ERG)in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy.

METHODS: Totally 32 patients(58 eyes)with type 2 diabetes mellitus(DM)without apparent diabetic retinopathy(DR)were detected by mf-ERG, from June 2014 to May 2015. Thirty cases(60 eyes)of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups.

RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased(t=3.099, P=0.012). The SOK b-wave latency in diabetes group was statistically delayed(t=2.643, P=0.025), and the SOK b-wave amplitude statistically decreased(t=4.833, P<0.01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus.

CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.