视野与糖尿病视网膜病变相关性的研究

目的研究视野指数与糖尿病视网膜病变（DR）程度的关系,以评估视野在DR诊断和随访中的临床价值。方法将DR患者按照DR的国际新分型分成4组（1期DR为D0组,2期DR为D1组,3期DR为D3组,4期DR为D4组）,采用瑞士Octopus101型全自动视野计,分别对4组患者（共40例40只眼）以及正常对照组（12例12只眼）行白/白视野（W/WP）和蓝/黄视野（B/YP）检查。结果 W/WP检查中,D0组患者的平均光敏感度（MS）和平均缺损（MD）与对照组比较,差异无统计学意义（P〉0.05）;其余各组与对照组比较,差异有统计学意义（P〈0.05）。B/YP检查中,各组患者的MS和MD与对照组比较,差异均有统计学意义（P〈0.05）。W/WP检查与B/YP检查的MD与DR分级呈正相关（r=0.724,P=0.000;r=0.688,P=0.000）,MS与DR分级呈负相关（r=-0.819,P=0.000;r=-0.578,P=0.000）。结论视野缺损与DR程度呈正相关,即视野缺损随着DR程度的增加而增加;蓝/黄视野可提示糖尿病患者早期视功能改变,在DR早期诊断中有一定的临床应用价值。

Research of relationship between visual field and diabetic retinopathy

Objective To research the relationship between perimetry index and diabetic retinopathy,and evaluate the clinical value of perimetry in diagnosis and following of diabetic retinopathy.Methods Diabetic retinopathy patients were divided into 4 groups according to the new international classification standard.Four DR groups(40 patients,40eyes) and control group(12 persons,12 eyes) were tested repeatedly with both white-on-white perimetry(W/WP) and blue-on-yellow perimetry(B/YP) with Octopus101 automatic perimeter produced by Switzerland.Results MS and MD of D0 group had unremarkable difference compared with those of the control group for W/WP(P>0.05),but those of the other three groups had remarkable difference compared with those of the control group for W/WP(P<0.05).MS and MD of all groups had remarkable difference compared with those of the control group for B/YP(P<0.05).MD was significantly associated to the degree of retinopathy,with a correlation coefficient of 0.724 for W/WP(P=0.000) and 0.688 for B/YP(P=0.000).MS had significantly negative correlation with the degree of retinopathy,with a correlation coefficient of-0.819 for W/WP(P = 0.000) and-0.578 for B/YP(P = 0.000).Conclusion Visual field loss increases with increasing severity of retinopathy.B/YP can indicate the early change of visual function,and has potential value in clinical application.