Trick G L, Burde R M, Gordon M O, Kilo C, Santiago J V
Washington University school of medicine, St. Louis, MO 63110.
Doc Ophthalmol. 1988 Sep;70(1):19-28. doi: 10.1007/BF00154732.
Clinically evident retinal vascular disease in patients with diabetes mellitus may be preceded by an increase in visual evoked potential latency in electrophysiologic testing. This increase may indicate either retinal or optic nerve dysfunction. To determine the origin of the latency increase we initiated a cross-sectional study of simultaneous pattern-reversal electroretinograms and visual evoked potentials. We recorded transient (3.8 reversals/second) pattern electroretinograms and visual evoked potentials using both 15' and 60' high-contrast black-white checks. Fifty-five diabetic patients (34 with no retinopathy and 21 with background retinopathy) and 34 age-matched visual normals (controls) were tested. Group data in diabetics showed significant latency increases in both tests, but not significant differences in retinocortical conduction time were noted. These results suggest that the increases in visual evoked potential latency exhibited by diabetic patients with little or no retinopathy usually reflect altered retinal function rather than optic neuropathy. Two patients with background retinopathy exhibited retinocortical conduction times that exceeded the normal mean by more than two standard deviations, suggesting that optic neuropathy may occasionally occur in diabetic patients with background retinopathy.
糖尿病患者临床上明显的视网膜血管疾病可能在电生理测试中视觉诱发电位潜伏期增加之前出现。这种增加可能表明视网膜或视神经功能障碍。为了确定潜伏期增加的起源，我们启动了一项同时进行图形翻转视网膜电图和视觉诱发电位的横断面研究。我们使用15'和60'高对比度黑白方格记录瞬态（3.8次翻转/秒）图形视网膜电图和视觉诱发电位。对55名糖尿病患者（34名无视网膜病变，21名有背景性视网膜病变）和34名年龄匹配的视力正常者（对照组）进行了测试。糖尿病患者的组数据显示两项测试中潜伏期均显著增加，但视网膜皮质传导时间无显著差异。这些结果表明，几乎没有或没有视网膜病变的糖尿病患者视觉诱发电位潜伏期的增加通常反映视网膜功能改变而非视神经病变。两名有背景性视网膜病变的患者表现出视网膜皮质传导时间超过正常平均值两个以上标准差，提示有背景性视网膜病变的糖尿病患者偶尔可能发生视神经病变。
