NPDR视乳头旁RNFL厚度及结构改变与视功能变化的相关性

Correlation between the peripapillary retinal nerve fiber layer thickness,structure changes in non-proliferative diabetic retinopathy and the changes of visual function

摘要:

目的：研究非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy，NPDR)视乳头旁视网膜神经纤维层(retinal nerve fiber layer，RNFL)的厚度及结构改变，及其与视功能变化的相关性。

方法：选取2011-01/2013-12于本院就诊的NPDR患者中80例80眼为NPDR组，同期在本院就诊的60例60眼无视网膜病变的糖尿病患者作为非糖尿病视网膜病变(non- diabetic retinopathy group，NDR)组，另选取同期在我院进行健康体检的50人作为对照组，对三组研究对象进行RNFL厚度及视觉电生理检查，并对其进行组间比较。

结果：NPDR组的上方、下方、鼻侧、颞侧及平均RNFL厚度分别为91.52±18.52，88.63±21.65，63.62±11.72，60.42±9.13，69.36±12.52μm； NDR组的分别为111.32±21.90，113.57±22.67，74.31±11.74，67.64±12.34，97.31±11.43μm； 对照组分别为121.65±21.42，129.32±23.31，82.42±9.28，80.32±8.51，102.54±21.82μm。三组的平均RNFL厚度相比较，NPDR组与NDR组均薄于对照组； 各象限间相比较，三组间的上方、下方及颞侧的RNFL厚度存在显著差异(P<0.05)，而鼻侧无显著变化(P>0.05)； 同时三组的60'P100潜伏期(ms)、60'P100振幅(μV)、15'P100潜伏期(ms)及15'P100振幅(μV)均存在显著差异(P<0.05)。

结论：在非增生期糖尿病视网膜病变的早期即已发生RNFL厚度的改变，以上方、下方及颞侧为主，且与视功能的变化呈显著相关性。

Abstract:

AIM:To study the correlation between and the peripapillary retinal nerve fiber layer(RNFL)thickness,structure changes in non-proliferative diabetic retinopathy(NPDR)and the the changes of visual function

METHODS:Eighty cases(80 eyes)of patients with NPDR who were in our hospital from January 2011 to December 2013 as group NPDR, 60 cases of patients(60 eyes)without retinopathy who were in the hospital were selected as non-diabetic retinopathy group(NRD)group, meanwhile, 50 healthy people who had health examination in our hospital as control group. The RNFL thickness and visual electrophysiological testing were performed on the study objects in the three groups, and the results were compared among groups.

RESULTS: Group NPDR's above, below, nasal, temporal and average RNFL thickness were 91.52±18.52, 88.63±21.65, 63.62±11.72, 60.42±9.13, 69.36±12.52μm,those of group NPDR were 111.32±21.90, 113.57±22.67, 74.31±11.74, 67.64±12.34, and 97.31±11.43μm,those of group control were 121.65±21.42, 129.32±23.31, 82.42±9.28, 80.32±8.51, 102.54±21.82μm. To compare of average thickness of RNFL of three groups, groups NPDR and NPD were thinner than that of control group; To compare each quadrant phase, above, below, nasal, the RNFL thickness among three groups had statistical significance(P<0.05), while nasal sides had no obviously changes(P>0.05); At the same time, 60'P100 latency(MS), 60'P100 amplitude(V), 15'P100 latency(MS)and 15'P100 amplitude(V)of three groups had statistical significance(P<0.05).

CONCLUSION: The changes of RNFL thickness have occurred in the early time of NPDR, and mainly the above, below and temporal, and it has a significant relevance with the changes of visual function.