| Objective: By observing visual field mean sensitivity(MS)value,mean visual field defects(MD),and the change of optic nerve fiber thickness of three groups of patients,which include normal person,diabetics without fundus changes,patients with mild non-proliferative diabetic retinopathy,we expect to analysis the structure and function of the patients diabetic retinopathy retinal nerve change.Methods: This study has selected normal person and diabetic patients from The Fourth Affiliated Hospital of China Medical University who had been hospitalized between March and October in 2017,with the disease duration ranged from 10 to 15 years.According to the standard set by American Academy of Ophthalmology(AAO)and International Federation of Ophthalmological society(IFOS),we decided to divide them into three separated groups.Group DR-0: patient with diabetic retinopathy and without fundus changes,including 25 patients,14 females and 11 males with 50 eyes,average age is(49.30±5.10).Group DR-1: patients with mild non-hypertrophic diabetic retinopathy(hemangioma capllanisum),27 cases including 14 females and13 males with 54 eyes,average age is(51.33±5.65).The control group was 25 people,including 15 male and 10 female with 50 eyes,average age is(50.18±5.58).We have preformed Field Vision and Optical coherence tomography(OTC)between patients in all these three groups,in order to observe the retinal nerve structure and functional changes.Results: the vision mean sensitivity in these three groups are: Control group(24.44±4.79 d B),Group DR-0(15.98±3.46 d B)and Group DR-1(11.07±4.95 d B),in which can be observed a trend of gradual declination(F=117.983 P<0.05).In term of Mean Deviation(MD),it can be observed that: Control group(4.50±1.49 d B);DR-0 group(7.18±2.96 d B),and DR-1 group(11.97±4.48 d B),in which can be noticed a trend of gradual increase,(F=70.432 P<0.05).There were statistically significant differences between the three groups(P<0.05).For the Retinal Nerve Fiber Layer(RNFL),we can see the results in Control group that: above(142.94±14.67um),below(139.42±12.21um),nasal side(84.08±13.71um)and temporal side(98.54±13.79um),in which the average figure is(116.24±7.53um).In Group DR-0 the results are: above(139.48± 22.63um),below(136.92 ±13.49um),nasal side(76.52± 13.47um),nasal side(89.04 ± 11.73um),in which the average figure is(110.49 ± 9.28um).In Group DR-1 the results is: above(129.54 ±21.58um),below(131.06±14.47um),nasal side(76.78±26.91um)and temporal side(80.96 ±14.80um)that averaged at(104.58± 13.29um).It can be seen from results above that the Retinal Nerve Fiber Layer(RNFL)were thinning in each group(Above F = 6.351 P < 0.05 Below F = 5.333 P < 0.05 Nasal side F = 2.490P>0.05 The temporal side F = 21.88 P < 0.05,averaged at F=18.51 P<0.05).Comparing pairwise in all these three groups,there was no statistically significant difference in RNFL in the upper,lower,and nasal side between the control group and the Group DR-0,and also,likewise with the nasal side of group DR-0 and DR-1,(P > 0.05).However,the statistically significant differences were seen between the rest pairwise groups(P<0.05).Conclusion: we have found that average visual field mean defect has increased in those diabetics without fundus changes and patients with mild non-proliferative diabetic retinopathy,however,for mean sensitivity the opposite happened.On the other side,their Retinal Nerve Fiber Layer(RNFL)had been witnessed to be thinner,which was happening above,below their optic disk,so did in their bitemporal and nasal side quadrant.These results suggest that the diabetics' neural function and structure had already changed before the retinopathy had been clinical observed. |
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