Proliferatif olmayan diabetik retinopatide renk algısı, karanlık adaptasyonu ve flaş elektroretinografi bulguları
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Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Proliferatif olmayan diabetik retinopatili (DR) olgularda renk algısı, karanlık adaptasyonu (KA) ve flaş elektroretinografi (fERG) parametrelerinin değerlendirilmesi. Yöntem: DR'li 31 hastanın 31 gözü ve 21 sağlıklı bireyin 21 gözü çalışmaya dahil edildi. Objektif refraksiyon, en iyi düzeltilmiş görme keskinliği ölçümleri ve biyomikroskopik ön segment ve fundus muayenesi, spektral domain optik koherens tomografi (SD-OCT) (Heidelberg Engineering, Heidelberg, Almanya) ile maküla analizi yapıldıktan sonra ChromaTest ile renk kontrast eşiği (RKE), Ganzfeld küresi (Metrovision, Perenchies, Fransa) ile KA ve fERG ölçümleri yapıldı. Elde edilen veriler arasındaki ilişki istatistiksel olarak değerlendirildi ve p<0,05 anlamlılık düzeyi olarak kabul edildi. Bulgular: DR grubunun yaş ortalaması 55,45±9,01 yıl, kontrol grubunun yaş ortalaması 54,86±5,61 yıldı. Erkeklerin yaş ortalaması 38,46±17,10, kadınların yaş ortalaması 34,72±13,59 yıldı. DR'li olguların 17'si (%54,8) erkek, 14'ü (%45,2) kadındı. Kontrol grubunun ise 12'si (%57,1) erkek, 9'u (%42,9) kadındı. Her iki grup arasında yaş ve cinsiyet açısından istatistiksel olarak anlamlı farklılık bulunmadı (p>0,05). DR ve kontrol grubu karşılaştırıldığında, tritan ve protan RKE değeri DR grubunda istatistiksel olarak anlamlı yüksek bulundu (p<0,001). KA maksimum duyarlılık değeri DR grubunda istatistiksel olarak anlamlı düşük bulundu (p<0,05). fERG ölçümünde istatistiksel olarak DR grubunda rod cevabı b dalgası latansı anlamlı olarak yüksek, maksimal cevap b dalgası latansı anlamlı olarak düşük, maksimal cevap a dalgası amplitüdü ise anlamlı olarak yüksek bulundu (p<0,05). Diğer fERG parametrelerinde her iki grup arasında istatistiksel anlamlı farklılık saptanmadı (p>0,05). DR grubunda cinsiyete göre yapılan karşılaştırmada RKE ve KA maksimum duyarlılık değerlerinde cinsiyetler arasında istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). fERG ölçümünde rod cevabı b dalgası amplitüdü kadın hastalarda istatistiksel olarak anlamlı yüksek bulundu (p<0,05). Diğer fERG parametrelerinde DR grubunda cinsiyetler arasında istatistiksel anlamlı farklılık saptanmadı iii (p>0,05). Kontrol grubu cinsiyete göre yapılan karşılaştırmada, protan RKE erkeklerde istatistiksel olarak yüksek saptandı (p<0,05). Tritan RKE'de ise cinsiyetler arası anlamlı fark izlenmedi (p>0,05). Maksimal cevap a dalgası amplitüdü kadınlarda istatistiksel olarak anlamlı yüksek saptanırken (p<0,05), KA maksimum duyarlılık değeri ve fERG parametrelerinde cinsiyetler arası anlamlı farklılık saptanmadı (p>0,05). DR ve kontrol grupları cinsiyetler açısından karşılaştırıldığında, hem erkek hem de kadın hastalar arasında RKE diabet grubunda istatistiksel olarak anlamlı yüksek saptandı (p<0,001). Diabetli kadınlarda, kontrol grubundaki kadınlara göre rod cevabı b dalga latansı istatistiksel olarak yüksek saptandı (p<0,05). KA maksimum duyarlılık değeri ve diğer fERG parametrelerinde istatistiksel olarak anlamlı farklılık saptanmadı (p>0,05). Diabetli erkeklerde kontrol grubundaki erkeklere göre, istatistiksel olarak rod cevabı b dalgası amplitüdü anlamlı düşük (p<0,05), maksimal cevap a dalgası amplitüdü anlamlı yüksek (p<0,001) ve maksimal cevap b dalgası latansı anlamlı düşük (p<0,001) bulundu. Diabetli olguların hastalık süresi ile parametreler arasında istatistiksel anlamlı ilişki saptanmadı (p>0,05). Diabet hastalarının yaşı ile maksimal cevap a dalgası latansı, maksimal cevap b dalgası latansı, kon cevabı b dalgası latansı değerleri arasında anlamlı derecede pozitif ilişki olduğu bulundu. Ek olarak diabet hastalarının yaşı ile maksimal cevap a dalgası amplitüdü, maksimal cevap b dalgası amplitüdü, kon cevabı b dalgası amplitüdü, fotopik negatif cevap (FNC) amplitüdü değerleri arasında istatistiksel olarak anlamlı derecede negatif ilişki olduğu bulundu (p<0,05). Diğer parametreler arasında istatistiksel anlamlı ilişki saptanmadı (p>0,05). Sonuç: DR'nin proliferatif olmayan evresinde fonksiyonel değişikliklerin saptanması, RKE, KA ve fERG ölçümleri ile mümkün olabilmektedir. RKE'de bozulmanın, fERG paramerelerindeki bozulmaya göre daha kuvvetli olması, proliferatif olmayan DR'de gelişen renk algı bozukluğunun, elektroretinografik değişimler başlamadan ortaya çıktığını göstermektedir.
This study aims to evaluate color perception, dark adaptation (DA), and flash electroretinography (fERG) findings in non-proliferative diabetic retinopathy (DR). Material and Methods: A total of 31 eyes of 31 DR patients and 21 eyes of 21 healthy individuals were included in the study. Objective refraction, best corrected visual acuity measurements and biomicroscopic anterior segment and fundus examination findings, macula analysis with spectral-domain optic coherence tomography (OCT) (Hedielberg Engineering, Heidelberg, Germany) followed by color contrast threshold (CCT) with ChromaTest, DA with Ganzfeld effect (Metrovision, Perenchies, FR), and fERG measurements were evaluated. The obtained data were statistically analyzed. P value of <0.05 was considered statistically significant. Results: Mean age of the DR group was 55.45±9.01 years, while mean age of the control group was 54.86±5.61 years. The mean age of males was 38.46 ± 17.10, and the mean age of females was 34.72 ± 13.59 years. The DR group consisted of 17 (54.8%) males and 14 (45.2%) females. The control group consisted of 12 (57.1%) males and 9 (42.9%) females. There was no statistically significant difference between the two groups in terms of age and gender (p> 0.05). Tritan and protan CCT measurements were significantly higher in the DR group (p<0.001). Maximum sensitivity value of DA was significantly lower in the DR group (p<0.05). In fERG measurements, the DR group had significantly higher rod response b-wave latency, significantly lower maximal response b-wave latency, and significantly higher maximal response a-wave amplitude (p<0.05). There was no significant difference in other fERG parameters between the two groups. (p>0.05). In the comparison of genders in the DR group, there was no significant difference between males and females according to CCT and DA maximum sensitivity values (p>0.05). Female patients had significantly higher rod response b-wave amplitude in fERG (p<0.05). There was no v significant difference in the other fERG parameters between the genders of the DR group (p>0.05). In the control group, males had significantly higher protan CCT compared to females (p<0.05), while there was no significant difference between the genders according to tritan CCT (p>0.05). Females had significantly higher maximal response a-wave amplitude (p<0.05) than males, while there was no difference in DA maximum sensitivity values and fERG parameters (p>0.05). When the DR and control groups were compared according to genders, CCT was significantly higher in the DR group in both males and females (p<0.001). Females with diabetes had significantly higher rod response b-wave latency compared to females in the control group (p<0.05), however, there was no significant difference in DA maximum sensitivity value and other fERG parameters (p>0.05). Males with diabetes had significantly lower rod response b-wave amplitude compared to those in the control group (p<0.05), significantly higher maximal response a-wave amplitude (p<0.001), and significantly lower maximal response b-wave latency (p<0.001). There was no statistically significant correlation between disease duration and parameters of patients with diabetes (p> 0.05). A significant positive correlation was found between age of diabetic patients and maximal response a-wave latency, maximal response b-wave latency, and cone response b-wave latency. In addition, a statistically significant negative correlation was found between the age of diabetic patients and the values of maximal response a-wave amplitude, maximal response b-wave amplitude, cone response b-wave amplitude, photopic negative response amplitude values (p<0.05). There was no statistically significant correlation between other parameters (p>0.05). Conclusion: The detection of functional changes is possible with CCT, DA and fERG measurements in the non-proliferative phase of DR. The finding that impairment in CCT is stronger than the impairment in the fERG parameters is indicative that color perception disorder that develops in the non-proliferative DR occurs before the start of electroretinographic changes.
This study aims to evaluate color perception, dark adaptation (DA), and flash electroretinography (fERG) findings in non-proliferative diabetic retinopathy (DR). Material and Methods: A total of 31 eyes of 31 DR patients and 21 eyes of 21 healthy individuals were included in the study. Objective refraction, best corrected visual acuity measurements and biomicroscopic anterior segment and fundus examination findings, macula analysis with spectral-domain optic coherence tomography (OCT) (Hedielberg Engineering, Heidelberg, Germany) followed by color contrast threshold (CCT) with ChromaTest, DA with Ganzfeld effect (Metrovision, Perenchies, FR), and fERG measurements were evaluated. The obtained data were statistically analyzed. P value of <0.05 was considered statistically significant. Results: Mean age of the DR group was 55.45±9.01 years, while mean age of the control group was 54.86±5.61 years. The mean age of males was 38.46 ± 17.10, and the mean age of females was 34.72 ± 13.59 years. The DR group consisted of 17 (54.8%) males and 14 (45.2%) females. The control group consisted of 12 (57.1%) males and 9 (42.9%) females. There was no statistically significant difference between the two groups in terms of age and gender (p> 0.05). Tritan and protan CCT measurements were significantly higher in the DR group (p<0.001). Maximum sensitivity value of DA was significantly lower in the DR group (p<0.05). In fERG measurements, the DR group had significantly higher rod response b-wave latency, significantly lower maximal response b-wave latency, and significantly higher maximal response a-wave amplitude (p<0.05). There was no significant difference in other fERG parameters between the two groups. (p>0.05). In the comparison of genders in the DR group, there was no significant difference between males and females according to CCT and DA maximum sensitivity values (p>0.05). Female patients had significantly higher rod response b-wave amplitude in fERG (p<0.05). There was no v significant difference in the other fERG parameters between the genders of the DR group (p>0.05). In the control group, males had significantly higher protan CCT compared to females (p<0.05), while there was no significant difference between the genders according to tritan CCT (p>0.05). Females had significantly higher maximal response a-wave amplitude (p<0.05) than males, while there was no difference in DA maximum sensitivity values and fERG parameters (p>0.05). When the DR and control groups were compared according to genders, CCT was significantly higher in the DR group in both males and females (p<0.001). Females with diabetes had significantly higher rod response b-wave latency compared to females in the control group (p<0.05), however, there was no significant difference in DA maximum sensitivity value and other fERG parameters (p>0.05). Males with diabetes had significantly lower rod response b-wave amplitude compared to those in the control group (p<0.05), significantly higher maximal response a-wave amplitude (p<0.001), and significantly lower maximal response b-wave latency (p<0.001). There was no statistically significant correlation between disease duration and parameters of patients with diabetes (p> 0.05). A significant positive correlation was found between age of diabetic patients and maximal response a-wave latency, maximal response b-wave latency, and cone response b-wave latency. In addition, a statistically significant negative correlation was found between the age of diabetic patients and the values of maximal response a-wave amplitude, maximal response b-wave amplitude, cone response b-wave amplitude, photopic negative response amplitude values (p<0.05). There was no statistically significant correlation between other parameters (p>0.05). Conclusion: The detection of functional changes is possible with CCT, DA and fERG measurements in the non-proliferative phase of DR. The finding that impairment in CCT is stronger than the impairment in the fERG parameters is indicative that color perception disorder that develops in the non-proliferative DR occurs before the start of electroretinographic changes.
Açıklama
Anahtar Kelimeler
Retinopati, Elektroretinografi
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Türk , H. B. (2020). Proliferatif olmayan diabetik retinopatide renk algısı, karanlık adaptasyonu ve flaş elektroretinografi bulguları. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Göz Hastalıkları Anabilim Dalı, Konya.
