【作者】 郝少峰；

【导师】 贾亚丁；

【作者基本信息】 山西医科大学 ， 眼科学， 2006， 硕士

【摘要】 目的：应用微视野(microprimetry MP1)检查技术对无糖尿病视网膜病变的糖尿病病人以及有糖尿病视网膜病变病人进行测定，探讨微视野在平均光敏感度和固视稳定性方面对糖尿病视网膜病变(diabetic retinopathy DR)的早期诊断意义，以及其在DR诊断上的临床意义。 方法：选取无DR的糖尿病病人(NDR组)21例42眼，有DR的病人(DR组)31例43眼，年龄匹配的健康志愿者30例60眼作为对照组，测量指标包括视力、2°视网膜平均光敏感度、12°视网膜平均光敏感度、固视稳定性和中心固视；同时比较DR组不同分期、不同眼底病理改变、以及后极部不同分区的光敏感度。 结果：与对照组比较，视力在NDR组无明显下降(P＞0.05)，而DR组视力明显降低(P＜0.01)；与NDR组比较，DR组视力明显降低(P＜0.01)。三组之间2°和12°视网膜平均光敏感度、中心固视、固视稳定性差别具有显著统计学意义(P＜0。001)。DR组不同病理改变的分为硬渗(8.58±3.98 dB)、水肿(6.18±2.80 dB)、软渗(4.84±2.72dB)和出血(3.02±5.01dB)，不同病理改变之间平均光敏感度比较差异无统计学意义(P＞0.05)。DR组后极部中心12°内不同分区平均光敏感度颞上组较鼻上组降低，差异有统计学意义(P＜0.05)；颞上组较鼻下组降低，差异有统计学意义(P＜0.01)。DR组2°和12°视网膜平均光敏感度与最佳矫正视力无相关关系(r=0.36、0.29，P＞0.05)。DR组不同分期之间比较，视力差异无统计学意义(P＞0.05)，2°和12°视网膜平均光敏感度差异无统计学意义。 结论：微视野在平均光敏感度和固视稳定性以及中心固视方面可以对DR进行早期诊断；DR病人颞上象限较其他部位更容易引起损伤。DR病人不同病理改变的平均光敏感度没有明显的差别。DR病人视力和中心光敏感度不相关。DR病人不同分期之间平均光敏感度无差别。更多还原

【Abstract】 Objective: Evaluation of mean light sensitivity and fixation stability in diabetic patients with or without diabetic retinopathy to investigate early diagnosis of diabetic retinopathy and clinical significance of diabetic retinopathy by using microprimetry (MP1).Methods: We studied 21 diabetic patients (42 eyes) without retinopathy (NDR group), 31 diabetic patients (43 eyes) with retinopathy (DR group) and 30 healthy volunteers matched with age. The visual acuity, 2° mean light sensitivity, 12° mean light sensitivity, fixation stability and central fixation were measured. At the same time, the light sensitivity of the various stages, the various pathological changes and the various areas in posterior pole of diabetic retinopathy were compared.Results: There was no significant differences in visual acuity of NDR group(P>0.05), but the visual acuity of DR group was significantly diseased than in control group(P<0.01); the visual acuity of DR group was significantly diseased than NDR group(P<0.01). There were significant differences in mean light sensitivity, fixation stability and central fixation( P<0.001). The various pathological changes of DR group are, hard exudates(8.58±3.98 dB ), macular edema, (6.18 ±2.80 dB) soft exudates (4.84±2.72dB) and hemorrhage(3.02±5.01dB). There were no significant differences in mean light sensitivity of them(P>0.05).The mean light sensitivity of superior—temporal in posterior pole was significantly diseased than in superior —nasal and inferior—nasal(P<0.01). Linear correlation analysis showed that the 2° and 12 ° mean light sensitivity of DR group were not correlated with corrected visual acuity(r=0.36% 0.29, P>0.05). In DR group there was no significant differences in mean light sensitivity and visual acuity of various stages(P>0.05).Conclusion: It is suggested that examination of mean light sensitivity, fixation stability and central fixation has certain clinical significance in early diagnosis of diabetic retinopathy. Compare to other areas, the superior—temporal in posterior pole of DR more be damaged. There were no significant differences in mean light sensitivity of the various pathological changes. The mean light sensitivity of DR group was not correlated with corrected visual acuity. There was no significant differences in mean light sensitivity and visual acuity of various stages.更多还原