Park Jason C, Chau Felix Y, Lim Jennifer I, McAnany J Jason
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., MC/648, Chicago, IL, 60612, USA.
Department of Bioengineering, University of Illinois at Chicago, 851 South Morgan St., Chicago, IL, 60607, USA.
Doc Ophthalmol. 2019 Oct;139(2):99-111. doi: 10.1007/s10633-019-09699-2. Epub 2019 Apr 23.
To evaluate three measures of inner retina function, the pattern electroretinogram (pERG), the photopic negative response (PhNR), and the post-illumination pupil response (PIPR) in diabetics with and without nonproliferative diabetic retinopathy (NPDR).
Fifteen non-diabetic control subjects and 45 type 2 diabetic subjects participated (15 have no clinically apparent retinopathy [NDR], 15 have mild NPDR, and 15 have moderate/severe NPDR). The pERG was elicited by a contrast-reversing checkerboard pattern, and the PhNR was measured in response to a full-field, long-wavelength flash presented against a short-wavelength adapting field. The PIPR was elicited by a full-field, 450 cd/m, short-wavelength flash. All responses were recorded and analyzed using conventional techniques. One-way ANOVAs were performed to compare the pERG, PhNR, and PIPR among the control and diabetic groups.
ANOVA indicated statistically significant differences among the control and diabetic subjects for all three measures. Holm-Sidak post hoc comparisons indicated small, nonsignificant reductions in the pERG (8%), PhNR (8%), and PIPR (10%) for the NDR group compared to the controls (all p > 0.25). In contrast, there were significant reductions in the pERG (35), PhNR (34%), and PIPR (30%) for the mild NPDR group compared to the controls (all p < 0.01). Likewise, there were significant reductions in the pERG (40%), PhNR (32%), and PIPR (32%) for the moderate/severe NPDR group compared to the controls (all p < 0.01).
Abnormalities of the pERG, PhNR, and PIPR suggest inner retina neural dysfunction in diabetics who have clinically apparent vascular abnormalities. Taken together, these measures provide a noninvasive, objective approach to study neural dysfunction in these individuals.
评估有无非增殖性糖尿病视网膜病变（NPDR）的糖尿病患者的三种视网膜内层功能指标，即图形视网膜电图（pERG）、明视负反应（PhNR）和光照后瞳孔反应（PIPR）。
15名非糖尿病对照受试者和45名2型糖尿病受试者参与研究（15名无临床明显视网膜病变[NDR]，15名有轻度NPDR，15名有中度/重度NPDR）。pERG由对比度反转棋盘格模式诱发，PhNR通过在短波长适应场背景下呈现的全视野长波长闪光来测量。PIPR由全视野450 cd/m短波长闪光诱发。所有反应均采用传统技术进行记录和分析。进行单因素方差分析以比较对照组和糖尿病组之间的pERG、PhNR和PIPR。
方差分析表明，所有这三种指标在对照组和糖尿病受试者之间存在统计学显著差异。Holm-Sidak事后比较表明，与对照组相比，NDR组的pERG（8%）、PhNR（8%）和PIPR（10%）有小幅、不显著的降低（所有p>0.25）。相比之下，与对照组相比，轻度NPDR组的pERG（35%）、PhNR（34%）和PIPR（30%）有显著降低（所有p<0.01）。同样，与对照组相比，中度/重度NPDR组的pERG（40%）、PhNR（32%）和PIPR（32%）有显著降低（所有p<0.01）。
pERG、PhNR和PIPR异常提示有临床明显血管异常的糖尿病患者存在视网膜内层神经功能障碍。综上所述，这些指标为研究这些个体的神经功能障碍提供了一种非侵入性的客观方法。
