Greenstein V C, Holopigian K, Hood D C, Seiple W, Carr R E
Department of Ophthalmology, New York University School of Medicine, Columbia University, New York, New York 10016, USA.
Invest Ophthalmol Vis Sci. 2000 Oct;41(11):3643-54.
To evaluate the nature and extent of retinal dysfunction in the macular and surrounding areas that occurs in patients with diabetes with clinically significant macular edema (CSME).
Eleven patients were evaluated before focal laser treatment. Multifocal electroretinogram (ERG) and full-field ERG techniques were used to assess the effects of diabetic retinopathy and CSME on macular, paramacular, and peripheral retinal function. A modified visual field technique was used to obtain local threshold fields. The relationship between local sensitivity changes and local ERG changes was determined.
Local ERG responses were significantly delayed and decreased in amplitude, and timing changes were observed in a larger area of the retina than amplitude changes. Visual field deficits were similarly widespread with marked sensitivity losses occurring in retinal areas with normal ERG amplitudes and in areas that appeared to be free of fundus abnormalities. Despite this similarity and the finding that retinal areas with elevated thresholds have timing delays, timing delays were not good predictors of the degree of threshold elevation.
The results demonstrate the widespread nature of timing deficits and visual field deficits that are associated with CSME.
评估患有具有临床意义的黄斑水肿（CSME）的糖尿病患者黄斑及周边区域视网膜功能障碍的性质和程度。
对11例患者在进行局部激光治疗前进行评估。采用多焦视网膜电图（ERG）和全视野ERG技术，评估糖尿病视网膜病变和CSME对黄斑、黄斑旁及周边视网膜功能的影响。采用改良视野技术获取局部阈值视野。确定局部敏感性变化与局部ERG变化之间的关系。
局部ERG反应明显延迟且振幅降低，视网膜中观察到时间变化的区域比振幅变化的区域更大。视野缺损同样广泛存在，在ERG振幅正常的视网膜区域以及似乎没有眼底异常的区域出现明显的敏感性丧失。尽管存在这种相似性，以及阈值升高的视网膜区域存在时间延迟这一发现，但时间延迟并不是阈值升高程度的良好预测指标。
结果表明与CSME相关的时间缺陷和视野缺损具有广泛的性质。
