| Objective:To explore the relationship between the thickness of the RNFL around the optic disc and the changes in visual function in diabetic patients with NDR.Methods:Retrospective case-control study.A collection of diabetic patients who attended the ophthalmology department of Qingdao Municipal Hospital from August 2019 to April2021.The patients who were diagnosed with NDR by standard ETDRS7 field fundus color photographs were collected with Hb A1 c values≤ 7% The patients were classified as the ideal blood glucose control group(group A),with 87 people in 174 eyes,and the patients with Hb A1 c value c>7% were classified as the poor blood glucose control group(group B),with 76 people in 152 eyes.Choose people who have no systemic diseases and ophthalmological diseases and are similar in age to the experimental group as the control group(group C),with a total of 60 cases and 120 eyes.Record all patients’ age,medical history,Hb Alc and other general conditions and the results of routine ophthalmic examinations such as vision,intraocular pressure,refractive power,and fundus.All research subjects were subjected to OCT inspection and analysis of the RNFL thickness in all directions of the optic disc,and P-VEP inspection and analysis in high and low frequency conditions P100 wave latency and amplitude change,static visual field inspection and analysis of MD and VFI.Analyze the variation trends of RNFL thickness in various directions next to the optic disc,P100 wave latency and amplitude,MD and VFI examination results under high and low frequency conditions,as well as the RNFL thickness and P100 wave latency and amplitude of each direction next to the optic disc,MD and VFI.Whether the functional results are relevant.Results: General situation: The differences in gender,age,vision,intraocular pressure and refractive status of the three groups of patients were not statistically significant(all P>0.05);in terms of disease course,the differences between the two groups A and B were not statistically significant(P>0.05).RNFL: The thickness of the upper RNFL next to the optic disc in group A is 112.278±7.418,the thickness of the lower RNFL is 107.463±10.769,the thickness of the nasal side RNFL is 78.019±6.217,the thickness of the upper RNFL next to the optic disc in group B is 93.896±7.092,and the thickness of the lower RNFL is 96.521±10.593.The thickness of the lateral RNFL is 66.896±5.925,the thickness of the upper RNFL next to the optic disc in group C is 113.450±10.344,the thickness of the lower RNFL is 116.800±11.669,and the thickness of the nasal RNFL is 87.633±8.244.The thickness of the RNFL next to the optic disc and the nasal side of group A is lower than that of group C.Thinning,the difference was statistically significant(all P <0.05),the upper,lower,and nasal RNFL thickness of group B was thinner than that of group C,the difference was statistically significant(all P <0.05),the upper and lower sides of the optic disc in group B The thickness of RNFL on the nasal side was thinner than that of group A,and the difference was statistically significant(all P <0.05).There was no significant difference in the average thickness of RNFL near the optic disc and on the temporal side of the three groups(all P>0.05).P100 wave latency and amplitude: The latency(ms)and amplitude(uv)of high frequency P100 in group A and the latency(ms)and amplitude(uv)of low frequency P100 were108.500±9.054,8.902±0.967,109.333±6.279,8.390±1.262,respectively,and group B were 115.417,respectively ±8.399,6.441±1.100,114.979±7.918,6.651±1.197,group C were 95.783 ± 6.712,12.380 ± 1.600,101.267 ± 7.408,11.191 ± 1.558,respectively.Compared with group C,the incubation period(high frequency + low frequency)of group A was longer and the amplitude(high frequency + low frequency)was reduced,and the difference was statistically significant(all P <0.05).Compared with group C,the incubation period(high frequency + low frequency)of group B was longer and the amplitude(High frequency + low frequency)decreased,the difference was statistically significant(all P<0.05).Compared with group A,the incubation period(high frequency + low frequency)of group B was longer and the amplitude(high frequency + low frequency)was reduced,and the difference was statistically significant(all P <0.05).MD and VFI: The MDs of group A,group B,and group C were-7.033±1.208,-9.241±1.164,-0.753 ± 0.156,and VFI were 0.912 ± 0.024,0.867 ± 0.033,0.971 ± 0.017,respectively.The MD and VFI of group A were lower than those of group C,and the difference was statistically significant(all P <0.05).The MD and VFI of group B were lower than that of group C,and the difference was statistically significant(all P <0.05).,VFI decreased,the difference was statistically significant(all P <0.05).There was a negative correlation between the RNFL thickness of the upper,lower,and nasal side of the optic disc in groups A,B,and C and the latency of P100(high frequency + low frequency)(all P <0.05),and the amplitude of P100(high frequency + low frequency)),MD and VFI are positively correlated(all P <0.05).Conclusion: 1.NDR diabetic patients have undergone degenerative changes in the optic nerve,and visual function has also been affected.2.The thickness of RNFL above,below,and nasal side of the optic disc is significantly correlated with P100 latency,amplitude,MD,and VFI at different frequencies. |
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