摘要
目的 观察糖尿病视网膜病变（DR）全视网膜激光光凝术（PRP）治疗后黄斑区视网膜功能与形态的改变.方法 前瞻性自身对照研究.34例增生前期或增生期并接受PRP治疗的DR患者57只眼纳入研究.在PRP治疗前和治疗后20 d,3、9个月以上分别进行最佳矫正视力、多焦视网膜电图（mfERG）、光相干断层扫描（OCT）检查.采用wilcoxon带秩和检验、卡方检验、方差分析Dunnett-t、LSD-t检验和spearman相关分析,对比分析了PRP治疗前及治疗后黄斑功能和黄斑中心凹视网膜的厚度变化及相互关系.结果 PRP治疗后9个月以上视力降低（Z=-2.292,P=0.022） mfERG检查结果显示,治疗后20 d 2环P_1波幅值密度降低（P=0.039）,3个月恢复到治疗前水平,9个月以上再度降低（P=0.014） 治疗后20 d,3、9个月以上3～5环P_1波幅值密度降低,20 d 3环P=0.000,4环P=0.001,5环P=0.000 治疗后3个月3环P=0.000,4环P=0.006,5环P=0.001 治疗后9个月以上3环P=0.000,4环P=0.000.5环P=0.000 治疗后9个月以上1环P.波幅值密度明显降低（P=0.050）.治疗后20 d黄斑中心视网膜厚度增加（P=0.007）,3个月恢复到治疗前水平（P=0.981）.PRP治疗后出现黄斑囊样变性6只眼,占10.5%.结论 PRP治疗后,DR黄斑功能出现一定程度降低,黄斑中心凹视网膜厚度出现一过性增加.mfERG和OCT联合应用可全面客观评价黄斑区功能和形态变化.
Objective To observe the functional and morphological changes of macular after panretinal photocoagulation（PRP）in the patients with diabetic retinopathy（DR）. Methods A total of 57 eyes of 34 patients with DR undergoing PRP were enrolled in this prospective and self-reflection study. Comparatively analyze the changes of the best visual acuity（BCVA）, optical coherence tomography （OCT） and multi-focal electroretinography （mfERG） before PRP, 20 days, 3 months and more than 9 months after PRP. Statistical analyses were performed by wilcoxon, chi-square, Dunnett-t, LSD-t tests and spearman related analyses. The changes of macular function and foveal retinal thickness before and after PRP were comparatively analyzed. Results BCVA of all patients reduced at 9 months after PRP（P= 0. 022）. The amplitude density of mfERG P1 of ring 2 decreased at 20 days after PRP（P= 0. 039）, then recovered at 3 months and decreased again at 9 months（P=0. 014）. The amplitude density of mfERG P1 of ring 3-5 decreased at 20 days, 3 months and more than 9 months after PRP（20 days： ring 3： P=0. 000, ring 4： P= 0. 001, ring 5：P=0.000 3 months： ring 3：P=0. 000, ring 4. P=0. 006, ring 5： P=0.001 more than 9 months： ring 3： P=0. 000,ring 4： P=0.000, ring 5： P=0. 000）. The amplitude density of mfERG P1 of ring 1 was significantly lower at 9 months after PRP（P=0. 050）. The foveal retinal thickness increased at 20 days after PRP（P = 0. 007）, then recovered at 3 months or later. Cystoid macular degeneration was found in 6 eyes（10. 5%） at 20 days after PRP. Conclusions After the treatment of PRP, there were some extend reduction of the macular function, a transient increase on foveal retinal thickness. Combined mfERG and OCT can be a comprehensively and objectively assessment of macular function and morphology.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2010年第2期120-123,共4页
Chinese Journal of Ocular Fundus Diseases
基金
黑龙江省科学技术厅国际科技合作项目（WB08B02）
