关键词: 糖尿病性黄斑水肿, 微视野, 固视率

Abstract: Objective To evaluate the visual function of diabetic macular edema (DME) patients by microperimetry, and evaluate the association of microperimetry measurements and visual acuity. Design Retrospective case series. Participants 220 eyes of 164 patients with DME were enrolled in Wuhan General Hospital of Chinese People's Liberation Army from April 2016 to January 2018. Methods All patients were examined with best corrected visual acuity (BCVA, logMAR), fluorescein fundus angiography (FFA), optical coherence tomography(OCT), full retinoscoppy, MAIA microperimetry. According to the fixation rate, the subjects were divided into 3 groups：stable fixation，relative unstable fixation, and unstable fixation. According to the difference of retinal sensitivity, 3 stages of fixation stability were divided: A1 (normal), A2 (suspicious), and A3 (abnormal), and the visual acuity of different retinal sensitivity groups in the fixation group were compared. Main outcome measures BCVA, average threshold (AT), 2 degree fixation rate (P1), 4 degree fixation rate (P2) and bivariate contour ellipse area for 63% (BCEA63), BCEA95. Results In patients with DME, the AT of stable group, relatively unstable group and unstable group was 23.55±3.90 dB, 20.87±6.04 dB, 19.30±5.41 dB, respectively (F=9.824，P=0.00). The BCVA (logMAR) of stable group, relatively unstable group and unstable group was 0.38±0.24, 0.59±0.29, 0.63±0.31, respectively (F=9.808，P=0.000). In the stable group, the BCVA of A1, A2 and A3 groups were 0.22±0.15, 0.36±0.21, 0.51±0.24, respectively (F=16.14, P＜0.001). In the patients of DME, logMAR BCVA was negatively correlated with AT（r=-0.712，P=0.000）、P1（r=-0.380，P=0.000）、P2 （r=-0.370，P=0.000）, and positively correlated with BCEA 63 (r=0.352, P=0.000), and BCEA95 (r=0.355, P=0.000). Multiple linear regression analysis showed that logMAR BCVA was independently affected by AT (OR=0.576，P=0.000) and P1（OR=0.800，P=0.000). Conclusion MAIA microperimetry can assess macular visual function in patients with DME. AT and P1 can be used as a good indicator for the evaluation of macular visual function and a predictor of logMAR BCVA. It can reflect the visual function of patients with DME. (Ophthalmol CHN, 2021, 30: 236-239)

Key words: dabetic macular edema, microperimetry, fixation rate