OCT及mfERG在DR早期及非增殖期中的应用  

Application of OCT and mfERG at early and non-proliferative stages of diabetic retinopathy

作　　者：裴存文[1,2] 冯雪梅[1] 史少阳[1] 胡娜[1] 王丽美[1] 王洪宇[2] 段运动[2] 

机构地区：[1]中国医科大学附属盛京医院眼科,中国辽宁省沈阳市110004 [2]中国河北省承德市中心医院眼科,067000

出　　处：《国际眼科杂志》2012年第6期1059-1062,共4页International Eye Science

摘　　要：目的:用光学相干断层扫描(optical coherence tomography,OCT)测定糖尿病视网膜病变早期(non-diabetes retinopathy,NDR)及非增殖期(non-proliferative diabetes retinopathy,NPDR)的视网膜形态学改变及用多焦视网膜电图(multifocal electroretinogram,mfERG)测定其视网膜电活动的改变,评价不同分期糖尿病视网膜病变(diabetic retinopathy,DR)的严重程度。方法:选取50～70岁的老年人30例30眼作为正常组,已确诊为2型糖尿病患者50例50眼做为实验组。分别在标准状态下行OCT及mfERG检查,并对结果进行统计学分析。结果:对于NPDR的患者,视网膜形态的变化:视网膜黄斑区大部分神经上皮层变厚,说明对于糖尿病这个危险因素,视网膜的功能在不断的下降,视网膜黄斑区神经上皮层在NDR中变化并不明显而在NPDR明显变厚,说明黄斑区形态在糖尿病早期变化并不大,随着糖尿病的病情加重,形态发生了很大变化。电生理学改变:mfERG的P1波随着病情的加重,其反应密度逐渐下降,在NDR就明显减低,而在NPDR,下降更为明显,说明在黄斑区,视网膜形态改变前,电活动已经减弱,在形态发生变化后,电活动的下降更为明显。结论:OCT联合mfERG测定黄斑区域的形态改变及电活动改变,两种检查手段在疾病的早期观察、随访和进一步治疗的选择上具有很高的应用价值。AIM：To evaluate the severity of different stages of diabetic retinopathy （DR）with optical coherence tomography （OCT） for the determination of retinal morphological changes of non-diabetic retinopathy （NDR） and non-proliferative diabetic retinopathy （NPDR） and with multifocal electroretinogram （mfERG） for the determination of changes in retinal electrical activity. METHODS：Totally 30 elderly people of 50-70 years （30 eyes） were taken as normal group,50 patients（50 eyes） with confirmed type 2 diabetes as experimental group. They were conducted OCT and mfERG examination in standard state, and the results were statistically analyzed. RESULTS：For patients with NPDR, retinal morphological changes showed that most of the neural epithelium of the macular area thickened, indicating that the retinal function was in continuous decline as for the risk factors of diabetes. Neural epithelium of the macular area didn＇t change obviously at NDR stage but obviously thickened at NPDR stage, indicating that the morphological changes of the macular area were not large in the early diabete, and with the exacerbations of diabetes, the morphology had great changes. Electrophysiological changes showed that the response density of mfERG P1 wave gradually decreased as the disease worsened, which significantly reduced at NDR stage, while at NPDR stage, declined more obviously, indicating that the electrical activity at the macular area had been weakened before retina morphological changes, which declined more obviously after morphological changes. CONCLUSION：Determinating the morphological and electrical activity changes of the macular area with OCT joint mfERG, both means had a high application value in the early observation, follow-up and further treatment options of the disease.

关 键 词：多焦视网膜电图 光学相干断层扫描 糖尿病视网膜病变 

分 类 号：R774.1[医药卫生—眼科]