Lung J C Y, Swann P G, Wong D S H, Chan H H L
Laboratory of Experimental Optometry Neuroscience, School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China.
Doc Ophthalmol. 2012 Oct;125(2):123-35. doi: 10.1007/s10633-012-9343-0. Epub 2012 Jul 25.
To investigate the correlations of the global flash multifocal electroretinogram (MOFO mfERG) with common clinical visual assessments--Humphrey perimetry and Stratus circumpapillary retinal nerve fiber layer (RNFL) thickness measurement in type II diabetic patients.
Forty-two diabetic patients participated in the study: Ten were free from diabetic retinopathy (DR), while the remainder suffered from mild to moderate nonproliferative diabetic retinopathy. Fourteen age-matched controls were recruited for comparison. MOFO mfERG measurements were made under high- and low-contrast conditions. Humphrey central 30-2 perimetry and Stratus OCT circumpapillary RNFL thickness measurements were also performed. Correlations between local values of implicit time and amplitude of the mfERG components [direct component (DC) and induced component (IC)], and perimetric sensitivity and RNFL thickness were evaluated by mapping the localized responses for the three subject groups.
MOFO mfERG was superior to perimetry and RNFL assessments in showing differences between the diabetic groups (with and without DR) and the controls. All the MOFO mfERG amplitudes (except IC amplitude at high contrast) correlated better with perimetry findings (Pearson's r ranged from 0.23 to 0.36, p < 0.01) than did the mfERG implicit time at both high and low contrasts across all subject groups. No consistent correlation was found between the mfERG and RNFL assessments for any group or contrast conditions. The responses of the local MOFO mfERG correlated with local perimetric sensitivity but not with RNFL thickness.
Early functional changes in the diabetic retina seem to occur before morphological changes in the RNFL.
研究全视野闪光多焦视网膜电图（MOFO mfERG）与II型糖尿病患者常见临床视觉评估—— Humphrey视野检查和Stratus环乳头视网膜神经纤维层（RNFL）厚度测量之间的相关性。
42例糖尿病患者参与了本研究：10例无糖尿病视网膜病变（DR），其余患者患有轻度至中度非增殖性糖尿病视网膜病变。招募了14名年龄匹配的对照者进行比较。在高对比度和低对比度条件下进行MOFO mfERG测量。还进行了Humphrey中心30-2视野检查和Stratus OCT环乳头RNFL厚度测量。通过绘制三组受试者的局部反应，评估mfERG成分[直接成分（DC）和诱发成分（IC）]的局部潜伏期值和振幅与视野敏感性和RNFL厚度之间的相关性。
在显示糖尿病组（有和无DR）与对照组之间的差异方面，MOFO mfERG优于视野检查和RNFL评估。在所有受试者组中，所有MOFO mfERG振幅（高对比度下的IC振幅除外）与视野检查结果的相关性（Pearson相关系数r范围为0.23至0.36，p<0.01）均优于高对比度和低对比度下的mfERG潜伏期。在任何组或对比度条件下，均未发现mfERG与RNFL评估之间存在一致的相关性。局部MOFO mfERG的反应与局部视野敏感性相关，但与RNFL厚度无关。
糖尿病视网膜的早期功能变化似乎发生在RNFL的形态学变化之前。
