非增生性糖尿病视网膜病变中心视网膜厚度与 PVEP 的相关性研究

摘要

目的：观察中心视网膜厚度对非增生性糖尿病视网膜病变（ NPDR）图形视觉诱发电位（ PVEP）的影响。方法总结2012年1月至2015年3月间我院眼科及内分泌科住院的NPDR患者，排除中心视网膜有明显的出血、渗出及有明显的其它眼底病变者，有完整的中心视网膜相干光断层扫描（ OCT）资料、视网膜电图资料及眼底血管造影资料的患者120例（240只眼），依据OCT测量（中心点1 mm、1～3 mm、3～6 mm直经范围）的中心视网膜厚度，按Zeiss cirrus400 OCT随机正常值范围将该组患者分为中心视网膜厚度正常组、中心视网膜厚度变薄组及中心视网膜厚度增厚组，观察患者的OCT中心视网膜厚度及PVEP指标，分析两者的相关性。结果中心视网膜厚度正常组中心视网膜平均厚度为276．4～304．9μm；3组患者眼PVEP的P100波潜伏期均有延迟，中心视网膜厚度变薄组较其它两组延迟更明显（ F ＝13．68、3．79， P ＝0．00、0．04），中心视网膜厚度变薄组PVEP的P100波潜伏期延迟最明显（ F ＝15．56， P ＝0．00）；中心视网膜厚度正常组PVEP的P100波振幅值变化不明显，中心视网膜厚度变薄组及中心视网膜厚度增厚组较中心视网膜厚度正常组PVEP的P100波振幅值显著降低（ F ＝9．65、19．36， P ＝0.00、0．00），中心视网膜厚度增厚组较中心视网膜厚度变薄组PVEP的P100波振幅值降幅更显著（ F ＝4．62， P ＝0．02）。结论 NPDR患眼中心视网膜厚度与PVEP指标有着明显的相关性。%Objective To observe the relationship between center retinal thickness and PVEP in non-proliferative diabetic retinopathy ( NPDR) .Methods Author retrospectively summarized the clinical data of NPDR patients diagnosed and treated in our hospital between January 2012 and March 2015.Patients were ruled out for other fundus conditions such as central retinal edema, hemorrhage, obviously ooze and other fundus lesions.Complete retinal OCT images, retinal elect-rodiagram and fundus angiography data of 120 cases (240 eyes) were collected.According to retinal thickness measured by OCT at different eccentricity (1 mm, 1~3 mm, and 3~6 mm) , patients were divided into normal, thin retina and thick retina groups.Relationships between retinal thickness and PVEP were studied.Results Retinal thickness was 276.4~304.9 um in normal group.PVEP P100 latency was delayed in all three NPDR groups, and the delay was more prominent in thin retina group than in two other groups ( F =13.68, 3.79;P =0.00, 0.04).Delay was longest in thin retina group.P100 amplitude significantly reduced in thin retina group and in thick retina group ( F =9.65, 19.36;P =0.00, 0.00) than in normal group.Lowest amplitude was found in thick retina group.Conclusion There was a clear relation-ship between PVEP and retinal thickness in NPDR patients.