Characteristics Of Multifocal Electroretinogram(mfERG) In Non-proliferative Diabetic Retinopathy

Purpose1.The first order of multifocal electroretinogram(mfERG)in non-proliferative diabetic retinopathy(NPDR)Observation of kennel reaction.2.To evaluate the clinical effect of intravitreal anti VEGF injection in the treatment of non-proliferative diabetic retinopathy and the effect of visual function recovery.Method1.The first order of multifocal electroretinogram(mfERG)in non-proliferative diabetic retinopathy(NPDR)Observation of kennel reaction:18 healthy normal people(22 eyes)who came to our hospital for physical examination without any eye diseases were randomly selected as the normal group.Those who were randomly selected from our hospital for outpatient treatment without any treatment were confirmed as non proliferative diabetic retinopathy by mydriatic fundus examination,fundus photography,high-definition optical coherence tomography and fundus fluorescein angiography 26 cases(45 eyes)were in NPDR group.All subjects were examined by the same doctor on the same RET-scan multifocal retinal electrophysiological instrument of Roland company in Germany.The general data of normal group and NPDR group were statistically analyzed,and the mfERG results of normal group and NPDR group were observed.Firstly,observe the corresponding first-order kennel reaction results of five rings,and make statistical analysis on the amplitude density and latency of PI wave and N1 wave.Secondly,take the fovea of macula as the center and divide the result area of mfERG into four quadrants,NI\NS\TS\TI,which is divided by the machine.The amplitude density and latency of P1 wave and N1 wave in four quadrants were statistically analyzed;thirdly,the general data of normal group and NPDR group were compared,and the difference between the amplitude density and latency of N1 wave and PI wave in mfERG results of normal group and NPDR group was compared,and the two groups of data were statistically analyzed.2.To evaluate the clinical effect of intravitreal anti VEGF injection in the treatment of non-proliferative diabetic retinopathy and the effect of visual function recovery:Eight patients(14 eyes)in NPDR group were required to receive intravitreal anti vascular endothelial growth factor(VEGF)for the purpose of improving vision.The 8 patients were enrolled into the injection group,and the therapeutic effect was evaluated 3-7 days after operation:the comparison of the best corrected visual acuity after operation and the best corrected visual acuity before operation.The function of retinal cone cells and nerve cells(mfERG).SPSS(IBM SPSS.20.Statistics)software was used for all data statistics and analysis.Results1.There were 22 eyes in the normal group.the average age was 56.77±13.71.45 eyes in the NPDR group,the average age of them was 55.36 ± 6.37.There was no statistical difference between the two groups(P=0.61).The average BCVA of the normal group was 83.41±3.16,and that of the NPDR group was 72 51±6.78.The BCVA of the normal group was better than that of the NPDR group(P(0.05).The results showed that the amplitude density of N1 in normal group showed the law of ring 1)ring 2)ring 3)ring 4.The amplitude density of P1 wave showed the law of ring 1)ring 2>ring 3>ring 4>ring 5.And the independent sample t-test between each two adjacent rings had statistical significance(P<0.05).The latency of PI wave in the normal group was significantly longer in ring 1 than in ring 2 to ring 4(P(0.05).In NPDR group,the amplitude density of N1 and P1 decreased from ring 1 to ring 5,and the independent sample t-test between each two adjacent rings had statistical significance(P(0.05).There was a linear correlation between the age and the amplitude density of fovea in normal people(R2=0.4035,P=0.0015).The older the age was,the smaller the amplitude density was.There was no correlation between the amplitude density of fovea and the age in NPDR group(R2=0.01784,P=0.3818).There was a linear correlation between the amplitude density and BCVA(R2=0.4337,P(0.0001).The larger the BCVA was,the greater the amplitude density was.Comparing with the normal group,the amplitude density in NPDR group P]wave of ring]and ring 2 in NPDR group was lower.Comparing the latency of mfERG results in two groups,the N1 wave latency of ring 2-ring 5 and P1 wave latency of ring 1-ring 5 in NPDR group were significantly longer than that in normal group.According to the mfERG results of four quadrants,there was no difference in the amplitude density and latency of N1 and P1 waves in four quadrants of Ni,NS,TS and Ti in the normal group.Different from the normal group,the amplitude density of P1 wave in NPDR patients was higher in the upper part of nasal superior(NS)than in the inferior part of nasal and temporal.The latency of N1 wave in the temporal superior part was shorter than that in the inferior part of nasal(P(0.05).There was no difference in amplitude density of N1 wave between NPDR group and normal group.The latency of NJ wave in NPDR group was significantly longer than that in normal group(P<0.05)The latency of PI wave in NPDR group was significantly longer than that in normal group(P<0.05).2.14 eyes in the injection group,the average age was 57±6.38.The average value of BCVA before operation was 72.5±6.60,and 75.71 ± 7.03 3-7 days after intravitreal injection of anti VEGF drugs(P=0.227).The results of mfERG showed that the amplitude density of N1 and P1 waves in ring 1 was significantly higher than that before injection(P<0.05),but still lower than that in normal people(P(0.05).There was no significant change in the amplitude density and latency of N1 and P1 waves in other rings.Conclusion1.MfERG decreased from macular fovea to peripheral retinal nerve function in healthy people and NPDR patients.In the process of retinal nerve function damage in NPDR patients,the nerve cells near macular fovea were damaged earlier and more seriously.The damage degree of different retinal areas was different,the lower part was more damaged than the upper part,and the temporal side was more damaged than the nasal side.2.Patients with NPDR who received anti VEGF treatment had little effect on vision in a short time,but improved the function of retinal cone cells and other nerve cells.