糖尿病黄斑水肿分级及其多焦视网膜电图改变的临床研究

发布时间：2018-05-29 21:53

本文选题：糖尿病视网膜病 + 糖尿病黄斑水肿　；参考：《重庆医科大学》2010年硕士论文

【摘要】： 目的:建立本实验室45-60岁正常人黄斑区不同直径范围视网膜神经上皮层厚度及多焦视网膜电图P1波振幅密度和潜伏期正常参考值;探讨糖尿病黄斑水肿的不同时期其多焦视网膜电图P1波振幅密度和潜伏期的相应变化。方法:首先建立本实验室45-60岁OCT扫描和mfERG检测的正常参考值,然后以OCT测定97例糖尿病患者192眼的视网膜黄斑区神经上皮层厚度,与相应的正常参考值比较,以糖尿病黄斑水肿国际临床分类法为标准,对糖尿病眼的黄斑水肿进行分级,再进行多焦视网膜电图P1波检测,并与相应正常参考值对比,分析多焦视网膜电图P1波随糖尿病性黄斑水肿不同时期的变化关系。结果:本实验室45-60岁正常人视网膜黄斑区神经上皮层平均厚度分九个区域测定,多焦视网膜电图潜伏期和振幅密度各按1~5环检测,并分别建立相应的正常参考值。192例糖尿病眼的DME分期如下:无DME:61眼,轻度DME:48眼,中度DME:44眼,重度DME:39眼。61例无明显DME眼一环平均振幅密度为60.95±18.25 nv/deg2 (P 0.05)。44例轻度DME眼,一环振幅密度为55.37±15.08 nv/deg2,二环振幅密度为34.04±9.86 nv/deg2,三环振幅密度为23.27±4.51nv/deg2 (P均 0.05)。48例中度DME眼一环潜伏期为49.32±4.03 ms,振幅密度为29.70±9.91 nv/deg2,二环潜伏期为46.20±3.81 ms,振幅密度为20.16±6.37 nv/deg2,三环振幅密度为14.76±3.88 nv/deg2,四环振幅密度为12.01±2.92 nv/deg2,五环振幅密度10.47±2.81 nv/deg2(P均0.05)。39例重度DME眼,一环潜伏期为49.99±5.16 ms,振幅密度为23.44±9.39 nv/deg2,二环潜伏期为48.34±4.34 ms,振幅密度为19.98±5.33 nv/deg2,三环潜伏期为45.64±3.99 ms,振幅密度为13.07±3.87 nv/deg2,四环潜伏期为44.53±4.07 ms,振幅密度为11.59±3.22 nv/deg2 ,五环振幅密度为8.88±2.27 nv/deg2 (P均0.05)。结论: OCT可对黄斑厚度进行定量测量,从而对DME准确分级,黄斑区不同的厚度对应相应的DME分级;糖尿病视网膜病患者DME不同时期,其mfERG P1波伴有相应的潜伏期延长和/或振幅密度降低等改变。光学相干断层成像术联合多焦视网膜电图,给我们提供了一种对糖尿病性黄斑病变做出早期预警的手段,从而能够让我们早期采取措施,预防糖尿病引起的视功能下降。
[Abstract]:Objective: to establish the retinal nerve epithelial layer thickness and the amplitude density and the normal reference value of the P1 wave of multi focal electroretinogram in the macular area of the normal 45-60 year old people in our laboratory, and to explore the corresponding changes in the amplitude density and latency of the P1 wave of the multi focal electroretinogram at different stages of diabetic macular edema.
Methods: first, the normal reference values of the 45-60 year old OCT scan and mfERG test in our laboratory were set up. Then the retinal macular layer thickness of the retinal area of 192 eyes of 97 patients with diabetes was measured by OCT. Compared with the corresponding normal reference values, the macular edema of diabetic eyes was graded by the international clinical classification of diabetic macular edema. The P1 wave of multifocal electroretinogram was detected and compared with the corresponding normal reference value, and the relationship between the P1 wave of the multifocal electroretinogram with the different periods of diabetic macular edema was analyzed.
Results: the average thickness of the retinal epithelia layer of retina was measured in nine regions in normal retina of 45-60 year old people in our laboratory. The latency and amplitude density of the multifocal electroretinogram were detected by 1~5 ring, and the corresponding normal reference values of.192 cases were established respectively as follows: no DME:61 eye, mild DME:48 eye, moderate DME:44 eye, severe DME:. The average amplitude density of one ring in the 39 eyes of 39 eyes was 60.95 + 18.25 nv/deg2 (P 0.05).44 mild DME eyes, the amplitude density of one ring was 55.37 + 15.08 nv/deg2, the amplitude density of the second ring was 34.04 + 9.86 nv/deg2, the amplitude density of the three ring was 23.27 + 4.51nv/deg2 (P mean 0.05), and the amplitude density was 49.32 + 4.03. For 29.70 + 9.91 nv/deg2, the latent period of the second ring is 46.20 + 3.81 MS, the amplitude density is 20.16 + 6.37 nv/deg2, the amplitude density of the three ring is 14.76 + 3.88 nv/deg2, the amplitude density of the fourth ring is 12.01 + 2.92 nv/deg2, the amplitude density of the five ring is 10.47 + 2.81 nv/deg2 (P 0.05).39 cases with severe DME eyes, and the latent period of the one ring is 49.99 + MS, and the amplitude density is + +. Nv/deg2, the latent period of the second ring is 48.34 + 4.34 MS, the amplitude density is 19.98 + 5.33 nv/deg2, the latent period of the three ring is 45.64 + 3.99 MS, the amplitude density is 13.07 + 3.87 nv/deg2, the Fourth Ring latent period is 44.53 + 4.07 MS, the amplitude density is 11.59 + 3.22 nv/deg2, and the amplitude density of the five rings is 8.88 + 2.27 nv/deg2 (P all).
Conclusion: OCT can be used for quantitative measurement of macular thickness so as to classify the DME accurately and the different thickness of the macular region corresponds to the corresponding DME classification. The mfERG P1 wave of diabetic retinopathy is associated with the corresponding latency prolongation and / or the decrease of amplitude density. Optical coherence tomography combined with multi focal electroretinogram. This provides us with an early warning of diabetic macular lesions that allows us to take early measures to prevent the decline of visual function caused by diabetes.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R587.1;R774.1

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