本文選題：糖尿病視網(wǎng)膜病 + 糖尿病黃斑水腫��； 參考：《重慶醫(yī)科大學》2010年碩士論文

【摘要】： 目的:建立本實驗室45-60歲正常人黃斑區(qū)不同直徑范圍視網(wǎng)膜神經(jīng)上皮層厚度及多焦視網(wǎng)膜電圖P1波振幅密度和潛伏期正常參考值;探討糖尿病黃斑水腫的不同時期其多焦視網(wǎng)膜電圖P1波振幅密度和潛伏期的相應變化。 方法:首先建立本實驗室45-60歲OCT掃描和mfERG檢測的正常參考值,然后以O(shè)CT測定97例糖尿病患者192眼的視網(wǎng)膜黃斑區(qū)神經(jīng)上皮層厚度,與相應的正常參考值比較,以糖尿病黃斑水腫國際臨床分類法為標準,對糖尿病眼的黃斑水腫進行分級,再進行多焦視網(wǎng)膜電圖P1波檢測,并與相應正常參考值對比,分析多焦視網(wǎng)膜電圖P1波隨糖尿病性黃斑水腫不同時期的變化關(guān)系。 結(jié)果:本實驗室45-60歲正常人視網(wǎng)膜黃斑區(qū)神經(jīng)上皮層平均厚度分九個區(qū)域測定,多焦視網(wǎng)膜電圖潛伏期和振幅密度各按1~5環(huán)檢測,并分別建立相應的正常參考值。192例糖尿病眼的DME分期如下:無DME:61眼,輕度DME:48眼,中度DME:44眼,重度DME:39眼。61例無明顯DME眼一環(huán)平均振幅密度為60.95±18.25 nv/deg2 (P 0.05)。44例輕度DME眼,一環(huán)振幅密度為55.37±15.08 nv/deg2,二環(huán)振幅密度為34.04±9.86 nv/deg2,三環(huán)振幅密度為23.27±4.51nv/deg2 (P均 0.05)。48例中度DME眼一環(huán)潛伏期為49.32±4.03 ms,振幅密度為29.70±9.91 nv/deg2,二環(huán)潛伏期為46.20±3.81 ms,振幅密度為20.16±6.37 nv/deg2,三環(huán)振幅密度為14.76±3.88 nv/deg2,四環(huán)振幅密度為12.01±2.92 nv/deg2,五環(huán)振幅密度10.47±2.81 nv/deg2(P均0.05)。39例重度DME眼,一環(huán)潛伏期為49.99±5.16 ms,振幅密度為23.44±9.39 nv/deg2,二環(huán)潛伏期為48.34±4.34 ms,振幅密度為19.98±5.33 nv/deg2,三環(huán)潛伏期為45.64±3.99 ms,振幅密度為13.07±3.87 nv/deg2,四環(huán)潛伏期為44.53±4.07 ms,振幅密度為11.59±3.22 nv/deg2 ,五環(huán)振幅密度為8.88±2.27 nv/deg2 (P均0.05)。 結(jié)論: OCT可對黃斑厚度進行定量測量,從而對DME準確分級,黃斑區(qū)不同的厚度對應相應的DME分級;糖尿病視網(wǎng)膜病患者DME不同時期,其mfERG P1波伴有相應的潛伏期延長和/或振幅密度降低等改變。光學相干斷層成像術(shù)聯(lián)合多焦視網(wǎng)膜電圖,給我們提供了一種對糖尿病性黃斑病變做出早期預警的手段,從而能夠讓我們早期采取措施,預防糖尿病引起的視功能下降。
[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.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R587.1;R774.1

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