Yamamoto S, Takeuchi S, Kamiyama M
Department of Ophthalmology, Toho University Sakura Hospital, Chiba, Japan.
Doc Ophthalmol. 1997;94(3):193-200. doi: 10.1007/BF02582978.
The short wavelength-sensitive (S-) cone electroretinogram (ERG) is selectively reduced in diabetic patients both with and without retinopathy, but the exact mechanism of the vulnerability of the S-cone system is still unclear. This study examined relationships of the S-cone ERG to systemic factors in diabetes. Cone ERGs to different color flash stimuli were examined in the presence of bright white background illumination in 17 diabetic patients without retinopathy and in 17 diabetics with background retinopathy. Relationships of the amplitude and implicit time of the S-cone ERG to the following systemic factors were statistically analyzed: patients' age, hemoglobin A1 level, method of diabetic control, presence of retinopathy, and presence of nephropathy. The amplitude of the S-cone ERG b-wave was significantly reduced in diabetics treated with insulin and in those associated with nephropathy. No significant correlation was found between the S-cone ERG and patient's age, hemoglobin A1 level and presence or absence of retinopathy. A selective reduction of the S-cone ERG is observed in patients whose metabolic control has been poor for a longer period, suggesting that microvascular changes may play a role in the S-cone ERG impairment.
糖尿病患者无论有无视网膜病变，其短波敏感（S）锥细胞视网膜电图（ERG）均有选择性降低，但S锥细胞系统易损的确切机制仍不清楚。本研究探讨了糖尿病患者中S锥细胞ERG与全身因素的关系。在17例无视网膜病变的糖尿病患者和17例有背景性视网膜病变的糖尿病患者中，于明亮白色背景照明下检测了对不同颜色闪光刺激的锥细胞ERG。对S锥细胞ERG的振幅和隐含时间与以下全身因素的关系进行了统计学分析：患者年龄、糖化血红蛋白A1水平、糖尿病控制方法、视网膜病变的存在情况以及肾病的存在情况。接受胰岛素治疗的糖尿病患者以及合并肾病的患者，其S锥细胞ERG的b波振幅显著降低。未发现S锥细胞ERG与患者年龄、糖化血红蛋白A1水平以及视网膜病变的有无之间存在显著相关性。在代谢控制长期较差的患者中观察到S锥细胞ERG有选择性降低，这表明微血管变化可能在S锥细胞ERG损害中起作用。
