糖尿病性视网膜病变早期mfERG的研究

目的:探讨糖尿病患者糖尿病性视网膜病变早期多焦视网膜电图(multifocal electroretinogram,mfERG)的特点。方法:应用德国ROLAND公司RETIscan系统对24例40眼糖尿病患者,同时对27例40眼正常对照眼记录mfERG。按机器的默认值一阶反应进行记录。整个记录过程中可以分为12个时段,每个时段记录为时间47秒。结果:mERG测得的糖尿病患者组1～5环所在位置的P1波的振幅密度随离心度的增加而降低,P1波和N1波幅值降低和潜伏时延迟。各象限的P1、N1波振幅密度、波幅值降低,潜伏时延迟。结论:糖尿病性视网膜病变受累的区域多发生在黄斑部,功能上的改变早于形态学的变化;病变的早期功能改变最先出现于视网膜的后极偏颞上方;糖尿病患者在未出现眼底改变时各个象限视网膜的外层已经严重受累。

An Analysis of mfERG in Early Diabetic Retinopathy

Objective:To investigate the characteristics of mfERG in diabetic retinopathy patients and to study the diagnostic sig- nificance of mfERG in early diabetic retinopathy.Methods:mfERG was examined on 40 eyes(24 patients)of diabetic retinopathy pa- tients and 40 eyes(27 persons)of normal control group with the RETIscan system(ROLAND Company,Germany).The whole record- ing process was divided into 12 periods of time,each of which was 47sec,and the result was recorded according to the first order re- sponse.Results:In diabetic group,the result from the mfERG showed that the vibration density of Plwave from ring 1 to 5 reduced grad- ually with acentric degree increasing,amplitude of vibration of wave P1 and N1 decreasing and the time of latency postponing.The den- sity and amplitude of vibration of wave P 1 and N 1 of all quadrants decreased while the time of latency postponed.Conclusions:Firstly, diabetic retinopathy takes place in macula area more frequently and the changes of function appear earlier than morphological changes do.Secondly,diabetic retinopathy and its earlier changes of function first appear on the posterior pole leaning to superior-temporal side. Lastly,diabetes patients without changes of diabetic retinopathy may already have severe damage in the outer layer of retina.