mf-ERG kernel反应在早期糖尿病视网膜病变检测中的意义  

Significance of the mf-ERG first & second order kernel in diabetic retinopathy detection

作　　者：严良 赵婕 丁琦 徐翀 秦洁 陆豪 

机构地区：[1]上海市宝山区中心医院眼科,201900

出　　处：《临床眼科杂志》2006年第3期207-209,共3页Journal of Clinical Ophthalmology

基　　金：上海市宝山区科学技术发展基金(02-A-25)

摘　　要：目的探讨糖尿病患者早期视网膜病变时视网膜功能的变化。方法对中心视力正常、眼底正常或为轻度非增生性糖尿病性视网膜病变的糖尿病患者分别行多焦视网膜电图(multifocal electroretinogram,mf- ERG)一、二阶kernel反应(first and second order kernel,FOK&SOK)检查。将结果正常同龄对照组比较。结果与对照组相比,糖尿病组1环(黄斑中心凹)的FOK P_1波振幅密度值降低,后极部30°视网膜总合反应的N_1、P_1波峰时延迟,差异有统计学意义(t=2.5492,P=0.0136；t=2.1124,P=0.0391和t=2.0241,P=0.0477)；糖尿病视网膜病变组1环(黄斑中心凹)的SOK P_1波振幅密度值降低,峰时延迟,后极部30°视网膜总合反应的P_1波振幅密度值降低,差异有统计学意义(t=2.7200,P=0.0086；t=2.5515,P=0.0136和t=2.7990,P=0.0070)。结论糖尿病眼中心视力尚正常时,由mf-ERG检得的黄斑中心凹和后极部视网膜功能已有异常；kernel反应异常表明早期糖尿病视网膜病变的内、外层视网膜功能均已受到损害,kernel反应的振幅和峰时是观察糖尿病视网膜病变的独立指标。Objective To observe the retinal function in early diabetic meUitus eyes. Methods The first and second order kernel （ FOK, SOK） response of the muhifocal electroretinogram （mf-ERG） were performed in the diabetic mellitus group, whom have the normal visual acuity, the normal retina or mild non-proliferative diabetic retinopathies. The FOK＆SOK were also tested and compared with the normal subjects. Results Compare with the normal, in the diabetic eyes group, the PI amplitude density of the FOK in Ringl （ macular fovea） was declined, and the Sum response of the N1＆P1 latency in the 30°post-polar retina were also delayed, which all have statistically differences（ t =2.5492, P =0. 0136; t =2. 1124, P =0.0391; t =2.0241, P =0.0477; respectively）. Same as in the diabetic eyes group, the PI amphtude density and latency of the SOK in Ringl （macular fovea） were all declined and delayed, and the Sum response of the PI amplitude density in the 30°post -polar retina was also declined, which all have statistically differences（ t = 2. 7200, P =0.0086; t =2.5515, P =0.0136; t =2.7990, P =0.0070; respectively）. Conclusion The function of the fovea detected by mf-ERG has been damaged even when visual acuities are still normal in the diabetic patients. The abnormality of the kernel manifests that the inner retina has been damaged, as well as the outer one in the early diabetic eye. The amplitude density and latency are the independent item when the diabetic retinopathy observed.

关 键 词：糖尿病性视网膜病变 黄斑中心凹 多焦视网膜电图 一 二阶kernel反应 

分 类 号：R774.1[医药卫生—眼科]