黄斑程序蓝/黄视野检查评估糖尿病性黄斑囊样水肿视功能的研究

目的 探讨黄斑程序蓝/黄视野检查在糖尿病性黄斑囊样水肿(cystoid macular edema,CME)诊断、预后判断及视功能评估中的作用.方法 收集糖尿病视网膜病变(diabetic retinopathy,DR)发生CME患者28例(28眼)(CME组),无CME患者24例(24眼)(NCME组),采用瑞士Octopus101型全自动视野计黄斑程序分别进行白/白视野(white-on-white perimetry,W/WP)和蓝/黄视野(blue-on-yellow perimetry,B/YP)检查,记录视野平均光敏感度(mean sensitivity,MS)值、平均缺损(mean defcct,MD)值等指标.结果 在W/WP检查中,NCME组MS值(26.23±2.71)dB显著大于CME组MS值(23.91±3.37)dB,差异有显著统计学意义(P＜0.01)；NCME组MD值(1.99±1.27)dB显著小于CME组MD值(4.33±1.92)dB,差异也有显著统计学意义(P＜0.01).在B/YP检查中,NCME组MS值(20.08±2.16)dB显著大于CME组MS值(15.13±2.24) dB,差异有显著统计学意义(P＜0.01)；NCME组MD值(6.63±2.30)dB显著小于CME组MD值(11.59±3.46)dB,差异有显著统计学意义(P＜0.01).W/WP检查MS(r=-0.357,P=0.009)、MD(r=-0.584,P＜0.01),与DR患者有无CME显著相关；B/YP检查MS(r=-0.753,P＜0.01)、MD(r=-0.645,P ＜0.01),也与DR患者有无CME显著相关.结论 视野检查尤其是黄斑程序B/YP是糖尿病性CME临床诊断、视功能评估的方法之一,可以作为DR常规检查项目,有利于CME的早期发现及疗效观察.

Blue-on-yellow visual field perimetry in evaluating visual function of diabetic cystoid macular edema

Objective To discuss the value of blue-on-yellow perimetry in diagnosis,prognosis and evaluating visual function for diabetic cystoid macular edema (CME).Methods Patients with diabetic retinopathy (DR) were selected in this study.Twenty-eight patients (28 eyes) with CME (CME group) and 24 patients (24 eyes) without CME (NCME group) underwent white-on-white perimetry (W/WP) and blue-on-yellow perimetry (B/YP) with Octopus 101 automatic perimetry. The data of mean sensitivity (MS) and mean defect (MD) were compared and analyzed.Results In W/WP,MS in NCME group (26.23±2.71) dB was obviously higher than that in CME group (23.91±3.37) dB,there was significant difference(P<0.01);MD in NCME group (1.99±1.27) dB was obviously smaller than that in CME group (4.33±1.92) dB,there was significant difference(P<0.01).In B/YP,MS in NCME group (20.08±2.16) dB was obviously higher than that in CME group (15.13±2.24) dB,there was significant difference(P<0.01);MD in NCME group (6.63±2.30) dB was obviously smaller than that in CME group (11.59±3.46) dB,there was significant difference(P<0.01).MS (r=-0.357,P=0.009) and MD(r=-0.584,P<0.01) in W/WP were correlated with the diagnosis of CME.MS(r=-0.753,P<0.01) and MD(r=-0.645,P<0.01) in B/YP were correlated with the diagnosis of CME.Conclusion Perimetry is one of the effective tools for detecting CME caused by DR,especially the blue-on-yellow perimetry,which can be set as the routine examination for DR to early diagnose the CME.