糖尿病性黄斑水肿玻璃体切除术后黄斑功能的评价

M. Abdelkader, M. Mamdouh, A. Fawzy
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引用次数: 1

摘要

目的:探讨玻璃体切除术对糖尿病患者视网膜功能及解剖结构的影响。方法:对25例30眼糖尿病性黄斑水肿患者(男11例,女14例)行玻璃体后面脱离的三孔玻璃体平面肌切除术。在玻璃体切除术前、术后1周、1个月、3个月分别进行视力(VA)检查、光学相干断层扫描(OCT)测量视网膜厚度、全视野视网膜电图(ERG)和多焦视网膜电图(MF-ERG)检查。结果:术后平均视力明显改善(P<0.05);术后3个月,视网膜平均厚度(从450±150微米降至220±50微米)显著降低(P=0.001),术后1周,所有玻璃体切除眼的ERG视锥和视杆反应的b波幅度均显著降低。1个月时,杆状反应仍未改善,但3个月后有所改善。在1个月内,在MF-ERG中检测到中央凹功能以及中央凹旁区域的减少。中心环MF-ERG平均P1波振幅增大,平均P1波隐含时间减小。在玻璃体切除术后3个月观察到这些MF-ERG参数的变化。结论:多焦视网膜电图可为糖尿病水肿玻璃体切除术前后的功能评价提供客观标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Macular Function after Vitrectomy in Diabetic Macular Edema
Purpose: To document the effects of successful vitrectomy on retinal function and anatomy in diabetic patients. Methods: Three-port pars plana vitrectomy with detachment of posterior vitrous face was performed in 30 eyes of 25 patients with diabetic macular oedema DME (11 male, 14 Female).For each patients, visual acuity (VA) examination, measurement of retinal thickness using optical coherence tomography (OCT), full field electro-retinogram (ERG) and multifocal eletroretinogram (MF-ERG) were performed before and 1week,1month and 3months after vitrectomy. Results: Mean postoperative visual acuity was significantly improved (P<0.05); mean retinal thickness was significantly (P=0.001 ) decreased after 3monthes of surgery (from 450±150 into 220±50 micron ) .b-wave amplitudes of all cone and rod responses of ERG were significantly decreased in all vitrectomized eyes after 1 week. At one month, rod response was still unimproved but improved after 3months. Reduction in foveal Function as well as in para-foveal areas detected in the MF-ERG within 1st month. Then, mean P1 wave amplitude of MF-ERG of central ring increased and mean P1 wave implicit time decreased. These changes of MF-ERG parameters observed 3 months after vitrectomy. Conclusion: Multifocal electroretinogram can be useful to provide objective criteria for functional evaluation before and after vitrectomy in diabetic oedema.
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