白内障术后糖尿病性视神经病变的检查与分析  

Examination and analysis of diabetic optic neuropathy after cataract surgery

作　　者：李双[1] 赵芳[1] 付汛安[1] 项奕[1] 

机构地区：[1]武汉市中心医院眼科430014

出　　处：《中华眼外伤职业眼病杂志》2016年第11期810-813,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金（81300761）

摘　　要：目的：分析白内障术后糖尿病性视神经病变（ DON）的荧光素眼底血管造影（ FFA）、光学相干断层扫描（OCT）、视觉诱发电位（VEP）和视野检查结果特点。方法对125例（235只眼）糖尿病患者在白内障术后行FFA、OCT、VEP和视野检查，分析相关数据。结果查出糖尿病视网膜病变（DR）70只眼（29.8%）；患DON者75只眼（31.9%）。 DON患者FFA主要表现为黄斑水肿、视盘水肿、充盈缺损或视盘新生血管。 OCT主要表现为黄斑区水肿、增厚或萎缩。 VEP表现为P100波潜伏期延长或振幅降低。视野损害呈多样化表现。结论发生白内障的糖尿病患者其DR和DON的发生率高。 FFA检查对早期诊断有重要意义。视网膜神经节细胞的损害在糖尿病早期就存在。Objective To analyse the characteristics of diabetic optic neuropathy （ DON ） in cataract patients with diabetes by using fluorescein fundus angiography （ FFA ） , optical coherence tomography （ OCT） , visual evoked potential （ VEP） and perimetry examination. Methods A total of 235 eyes of 125 cataract patients with diabetes were included in the study. These patients received cataract surgery and performed with FFA, OCT, VEP and perimetry examination postoperatively. The examination results and clinical characteristics of diabetic retinopathy （ DR） and DON were analyzed. Results Seventy eyes （29. 8%） were diagnosed with DR, 75 eyes （ 31. 9%） were diagnosed with DON. FFA in DON patients showed macular edema, optic disc edema, filling defect and optic disc neovascularization. OCT mainly showed macular edema, thickening or atrophy. VEP mainly showed prolonged P100 wave latency or decreased wave amplitude. Perimetry examination showed various kinds of insults. Conclusion DR and DON show a high occurrence rate in diabetes mellitus patient with cataract. FFA plays a key role in the early diagnosis of DR and DON. Retinal ganglion cells are damaged in patients with early DR.

关 键 词：视神经病变 糖尿病性 检查 白内障术后 荧光素眼底血管造影 光学相干断层扫描 视觉诱发电位 

分 类 号：R779.66[医药卫生—眼科] R587.2[医药卫生—临床医学] R774.6