玻璃体切割术对PDR患者黄斑区视网膜结构及功能的影响

目的:观察增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体切割术前与术后黄斑区视网膜结构及功能的变化.方法:对33例44眼行玻璃体切割术的PDR患者及30例44眼正常对照组采用光学相干断层扫描(optical coherence tomography,OCT)及多焦视网膜电图(multifocal electroretinogram,mf-ERG)进行检查,观察PDR患者术前与术后及正常对照组黄斑区视网膜厚度的改变及P1波、N1波5环和4象限的振幅密度及潜伏期的变化.结果:术后随访2mo,正常对照组、PDR患者组术前及术后两两比较:P1波振幅密度正常组及PDR组术前、术后两两比较,5环及4象限差异均有统计学意义(P＜0.05);P1波潜伏期1环正常对照组与PDR组术前比较,3,4,5环正常对照组与PDR组术后比较,第2,3象限正常对照组与PDR组术后比较差异无统计学意义(P＞0.05),其余均有统计学意义(P ＜0.05);N1波振幅1环正常对照组与PDR组术后比较,无统计学意义(P＞0.05),其余均有统计学意义(P ＜0.05);N1波潜伏期3环PDR组术前及术后比较,差异无统计学意义(P＞0.05),其余均有统计学意义(P＜0.05);黄斑中心凹视网膜厚度两两比较,差异均有统计学意义(P＜0.05).结论:玻璃体切割术可有效改善视网膜的感光及传导功能,从而成为治疗该病并改善部分视力的有效方法.

Effect of vitrectomy on retinal structure and function in macular area of patients with PDR

AIM:To observe the change of retinal structure and function in macular area of patients with proliferative diabetic retinopathy(PDR) before and after vitrectomy.METHODS:Thirty-three patients(44 eyes)of PDR with vitrectomy and 30 cases(44 eyes)of normal control group were inspected with optical coherence tomography(OCT) and multifocal electroretinogram(mf-ERG),the change of retinal thickness in macular area and amplitude densities and latencies of P1 wave and N1 wave(5 rings and 4 quadrants)were observed before and after vitrectomy and normal control group.RESULTS:Patients were followed up 2 months,normal control group and patients with PDR before and after vitrectomy pairwise comparison:normal control group and patients group before and after vitrectomy about amplitude densities of P1 wave(five rings and four quadrants) were pairwise compared,the differences were statistically significant(P<0.05);for the latencies of P1 wave,the normal control group compared with the preoperative patients about the first ring,the normal control group compared with postoperative patients about the third,forth,fifth ring,the normal control group compared with postoperative patients about the second,third quadrant,the differences were not statistically significant(P>0.05),the rest were statistically significant(P<0.05);the amplitude of N1 wave about the first ring in normal control group compared with postoperative patients,the differences were not statistically significant(P>0.05),the rest were statistically significant(P<0.05);the latencies of N1 wave about the third ring in preoperative patients compared with postoperative patients,the differences were not statistically significant(P>0.05),the rest were statistically significant(P<0.05);normal control group and patients with PDR before and after vitrectomy were pairwise compared in central fovea of macula about retinal thickness,the differences were statistically significant(P<0.05).CONCLUSION:Vitrectomy can improve photosensitive and conductive function of the retina effectively,thus becoming an effective way for the treatment of the disease and to improve part of the vision.