Lonneville Yildiz H, Ozdek Sengül C, Onol Merih, Yetkin Ilhan, Gürelik Gökhan, Hasanreisoğlu Berati
School of Medicine, Gazi University, Ankara, Turkey.
Ophthalmologica. 2003 Sep-Oct;217(5):347-50. doi: 10.1159/000071350.
To evaluate the effect of blood glucose (BG) regulation on the retinal nerve fiber layer (RNFL) in diabetic patients by using a scanning laser polarimeter (NFA-GDx).
We prospectively assessed RNFL thickness in diabetic patients and an age-matched control group. Patients without diabetic retinopathy, with BG >250 mg/dl, HbA1c >8%, fructosamine >285 micromol/l and triglyceride >200 mg/dl were included in the study. RNFL assessment was performed before and after metabolic regulation of diabetes. Symmetry, superior maximum, ellipse modulation and the average thickness variables of NFA-GDx were used for the assessment. Mann-Whitney U and Wilcoxon tests were used for the statistical analysis.
A total of 40 diabetic patients were included in the study and a repeat RNFL examination could be performed in 22 of them following regulation of BG levels. None of the GDx variables were significantly different between pre- and postregulation measurements (p > 0.05, Wilcoxon test). The mean superior maximum, ellipse modulation and average thickness values of the diabetic group were significantly lower than the control group (p < 0.05, Mann-Whitney U-test).
Poor metabolic control of diabetes mellitus adversely affects the thickness of RNFL and this effect does not seem to be acute since it was not reversed by short-term BG regulation. This issue needs to be kept in mind when assessing glaucomatous progress in diabetic patients.
使用扫描激光偏振仪（NFA-GDx）评估血糖（BG）调节对糖尿病患者视网膜神经纤维层（RNFL）的影响。
我们前瞻性地评估了糖尿病患者和年龄匹配的对照组的RNFL厚度。纳入研究的患者为无糖尿病视网膜病变、血糖>250mg/dl、糖化血红蛋白>8%、果糖胺>285μmol/l且甘油三酯>200mg/dl的患者。在糖尿病代谢调节前后进行RNFL评估。使用NFA-GDx的对称性、上方最大值、椭圆调制和平均厚度变量进行评估。采用Mann-Whitney U检验和Wilcoxon检验进行统计分析。
共有40名糖尿病患者纳入研究，其中22名在血糖水平调节后可进行重复RNFL检查。调节前后测量的GDx变量均无显著差异（p>0.05，Wilcoxon检验）。糖尿病组的平均上方最大值、椭圆调制和平均厚度值显著低于对照组（p<0.05，Mann-Whitney U检验）。
糖尿病代谢控制不佳会对RNFL厚度产生不利影响，且这种影响似乎不是急性的，因为短期血糖调节并不能逆转它。在评估糖尿病患者的青光眼进展时需要牢记这一问题。
