背景:糖尿病性视网膜病变(DR)是视网膜的神经退行性疾病。我们研究的目的是分析2型糖尿病患者的全视野视网膜电图(ERG)的潜伏期变化。
方法:这项前瞻性研究包括15例无DR的糖尿病患者,16例糖尿病患者非增生性DR,14例增殖前DR患者,15例增殖性DR,和14个年龄匹配的对照。所有参与者均接受眼科检查和全视野ERG检查。ERG用MetrovisionMonPackOne系统记录。在黑暗适应(DA)0.01ERG中分析了“a”和“b”波的潜伏期,DA3.0ERG,DA振荡电位,光适应(LA)3.0ERG,和30Hz闪烁ERG。
结果:与没有DR的糖尿病患者相比,健康受试者的延迟反应是DA振荡电位(25.45±1.04msvs.26.15±0.96ms,p=0.027)。当比较无DR和非增殖性DR的糖尿病患者时,我们没有获得统计学上显著的延迟.DA0.01“b”波的显著延迟(61.91±5.52ms与66.36±8.12ms,p=0.029),DA3.0“b”波(41.01±2.50msvs.44.16±3.78ms,p=0.035),和LA3.0“a”波(16.21±0.91msvs.16.99±1.16ms,在非增殖DR和增殖前DR之间发现p=0.045)。比较增殖前DR和增殖前DR患者组,LA3.0ERG“b”波(32。63±2.53msvs.36.19±3.21ms,p<0.0001),LA30Hz闪烁ERG“a”波(19.56±3.59vs.21.75±4.74ms,p=0.025),和“b”波(32.23±4.02vs.36.68±3.48ms,p=0.017)被延迟。
结论:我们研究的电生理学发现表明,在DR的所有阶段,神经视网膜都存在实质性的功能障碍。
BACKGROUND: Diabetic retinopathy (DR) is a neurodegenerative disease of the retina. The aim of our study was to analyze latency changes in a full-field electroretinogram (ERG) in patients with type 2 diabetes.
METHODS: This prospective study included 15 diabetic patients without DR, 16 diabetic patients with non-proliferative DR, 14 patients with pre-proliferative DR, 15 patients with proliferative DR, and 14 age-matched controls. All the participants underwent ophthalmologic examination and full-field ERGs. The ERGs were recorded with the Metrovision MonPackOne system. The latencies were analyzed for \"a\"- and \"b\"-waves in the dark-adapted (DA) 0.01 ERG, DA 3.0 ERG, DA oscillatory potentials, light-adapted (LA) 3.0 ERG, and 30 Hz flicker ERG.
RESULTS: The delayed responses of healthy subjects compared to diabetic patients without DR were the DA oscillatory potentials (25.45 ± 1.04 ms vs. 26.15 ± 0.96 ms, p = 0.027). When comparing diabetic patients without DR and with non-proliferative DR, we did not obtain statistically significant delays. Significant delays in the DA 0.01 \"b\"-wave (61.91 ± 5.52 ms vs. 66.36 ± 8.12 ms, p = 0.029), DA 3.0 \"b\"-wave (41.01 ± 2.50 ms vs. 44.16 ± 3.78 ms, p = 0.035), and LA 3.0 \"a\"-wave (16.21 ± 0.91 ms vs. 16.99 ± 1.16 ms, p = 0.045) were found between non-proliferative DR and pre-proliferative DR. When comparing the groups of patients with pre-proliferative DR and proliferative DR, the LA 3.0 ERG \"b\"-wave (32. 63 ± 2.53 ms vs. 36.19 ± 3.21 ms, p < 0.0001), LA 30 Hz flicker ERG \"a\"-wave (19.56 ± 3.59 vs. 21.75 ± 4.74 ms, p= 0.025), and \"b\"-wave (32.23 ± 4.02 vs. 36.68 ± 3.48 ms, p = 0.017) were delayed.
CONCLUSIONS: the electrophysiological findings from our study indicate that there is a substantial dysfunction of the neural retina in all stages of DR.