Parisi V, Uccioli L
Cattedra di Clinica Oculistica, Università di Roma Tor Vergata, Rome, Italy.
Diabetes Metab Res Rev. 2001 Jan-Feb;17(1):12-8. doi: 10.1002/dmrr.177.
Persons with type 1 diabetes show electrophysiological abnormalities of the visual system which are revealed by methods such as flash electroretinogram (FERG), oscillatory potentials (OPs), pattern electroretinogram (PERG), focal electroretinogram (focal ERG), visual evoked potentials (VEP) in basal condition and after photostress. This review reports the changes in electrophysiological responses of the different structures composing the visual system observed in persons with type 1 diabetes before the development of the overt clinical retinopathy. In persons with type 1 diabetes without retinopathy (IDD), the earlier abnormal electrophysiological responses are recorded from the innermost retinal layers and postretinal visual pathways, as suggested by impaired PERGs and delayed retinocortical time (RCT). These are observed in IDD persons with a disease duration shorter than 6 months. Further electrophysiological changes are recorded from the macula (abnormal focal ERG and VEP after photostress) in IDD persons with disease duration greater than 1 year. Additional electrophysiological changes are recorded from the middle and outer retinal layers (impaired FERG and OPs) in IDD persons with a disease duration greater than 10 years. All the electrophysiological tests show a greater degree of abnormal responses in persons with type 1 diabetes when a background retinopathy is present.
1型糖尿病患者存在视觉系统的电生理异常，这些异常可通过闪光视网膜电图（FERG）、振荡电位（OPs）、图形视网膜电图（PERG）、局灶性视网膜电图（局灶性ERG）、基础状态下及光应激后的视觉诱发电位（VEP）等方法检测出来。本综述报告了在1型糖尿病患者出现明显临床视网膜病变之前，观察到的构成视觉系统的不同结构的电生理反应变化。在无视网膜病变的1型糖尿病患者（IDD）中，最早出现异常的电生理反应记录于视网膜最内层和视网膜后视觉通路，这可通过PERG受损和视网膜皮质时间（RCT）延迟得以提示。在病程短于6个月的IDD患者中可观察到这些情况。在病程超过1年的IDD患者中，可记录到黄斑区的进一步电生理变化（光应激后局灶性ERG和VEP异常）。在病程超过10年的IDD患者中，可记录到视网膜中层和外层的额外电生理变化（FERG和OPs受损）。当存在背景性视网膜病变时，所有电生理检查均显示1型糖尿病患者的异常反应程度更高。
