Karacorlu M, Ozdemir H, Senturk F, Arf Karacorlu S, Uysal O
The Istanbul Retina Institute Inc., Istanbul, Turkey.
Eur J Ophthalmol. 2008 Jul-Aug;18(4):601-8. doi: 10.1177/112067210801800417.
The purpose of this study was to assess macular function by multifocal electroretinography (mfERG) in eyes with diabetic macular edema (DME) after intravitreal triamcinolone acetonide (IVTA) injection.
Fifteen eyes of 15 patients with DME scheduled for 4 mg IVTA injection were prospectively recruited. The response to treatment was monitored functionally by visual acuity (VA) measurement and mfERG and anatomically by foveal thickness measured by optical coherence tomography (OCT). The first-order kernel P1 mfERG responses from 0 to 7 degrees (central) and 7 to 25 degrees (peripheral) were grouped and analyzed. Changes in functional parameters (VAs and the P1 mfERG response amplitudes and peak latencies) and morphometric parameters (OCT foveal thickness) in eyes with DME 1 and 3 months after IVTA injection were compared with baseline values by Student t test.
The mean baseline logMAR value for VAs of the patients before treatment was 0.49+/-0.26. After treatment, it was 0.27+/-0.23 at 1 month and 0.26+/-0.18 at 3 months, and differences from pretreatment values were significant (for each, p<0.001). There were statistically significant decreases in the mean foveal thickness at 1 and 3 months after treatment compared with pretreatment values (for each, p<0.001). There were also statistically significant increases in the mean P1 response amplitude for both central and peripheral groups at all examinations compared with pretreatment (for each, p<0.001). The mean P1 peak latencies for both the central and peripheral groups were shortened, but not significantly.
As well as the reduction in DME and improvement in VA, IVTA injection improves macular function as assessed by mfERG in diabetic patients.
本研究旨在通过多焦视网膜电图（mfERG）评估玻璃体内注射曲安奈德（IVTA）后糖尿病性黄斑水肿（DME）患者眼睛的黄斑功能。
前瞻性招募了15例计划接受4mg IVTA注射的DME患者的15只眼睛。通过视力（VA）测量和mfERG从功能上监测治疗反应，通过光学相干断层扫描（OCT）测量黄斑中心凹厚度从解剖学上监测治疗反应。将0至7度（中央）和7至25度（周边）的一阶核P1 mfERG反应进行分组并分析。通过Student t检验将IVTA注射后1个月和3个月DME患者眼睛的功能参数（视力和P1 mfERG反应振幅及峰潜伏期）和形态学参数（OCT黄斑中心凹厚度）的变化与基线值进行比较。
患者治疗前VA的平均基线logMAR值为0.49±0.26。治疗后，1个月时为0.27±0.23，3个月时为0.26±0.18，与治疗前值的差异具有统计学意义（均为p<0.001）。与治疗前值相比，治疗后1个月和3个月黄斑中心凹平均厚度有统计学意义的降低（均为p<0.001）。与治疗前相比，所有检查中中央和周边组的平均P1反应振幅也有统计学意义的增加（均为p<0.001）。中央和周边组的平均P1峰潜伏期均缩短，但无统计学意义。
除了DME减轻和VA改善外，IVTA注射还可改善糖尿病患者经mfERG评估的黄斑功能。
