Fujioka Sayuri, Karashima Kaoruko, Nishikawa Norikiyo, Saito Yoshihiro
Department of Ophthalmology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Jpn J Ophthalmol. 2004 Jan-Feb;48(1):59-64. doi: 10.1007/s10384-003-0005-3.
To evaluate ocular findings and blood flow characteristics in diabetes mellitus (DM) patients with low serum albumin (ALB).
We studied 106 eyes of 53 type II DM patients without proliferative diabetic retinopathy and panretinal photocoagulation. All underwent standard ophthalmic examinations, color Doppler imaging, and serum ALB measurements. The patients were divided into Group 1 (34 cases) with a serum ALB > or =3.8 g/dl and Group 2 (19 cases) with ALB<3.8 g/dl.
All of the optic disks appeared normal by Ophthalmoscopy except one case with the lowest serum ALB. The number of optic disks showing late fluorescein staining was significantly higher in Group 2 than in Group 1. Peak systolic velocities in the central retinal artery (CRA, P=0.02) and central retinal vein (CRV, P<0.001) were significantly higher in Group 2, and significantly correlated with the serum ALB value (CRA; r=0.41, P=0.003 and CRV; r=0.60, P<0.001).
We suggest that low serum ALB enhances the permeability of the vessels in or around the optic disk and induces subclinical optic disk edema, which is characterized by late fluorescein staining and high blood flow velocities in the CRA and CRV.
评估血清白蛋白(ALB)水平低的糖尿病(DM)患者的眼部表现和血流特征。
我们研究了53例无增殖性糖尿病视网膜病变且未接受全视网膜光凝治疗的II型糖尿病患者的106只眼。所有患者均接受了标准眼科检查、彩色多普勒成像和血清ALB测量。患者被分为血清ALB≥3.8 g/dl的第1组(34例)和ALB<3.8 g/dl的第2组(19例)。
除1例血清ALB水平最低的患者外,所有眼底镜检查的视盘均正常。第2组中出现晚期荧光素染色的视盘数量显著高于第1组。第2组视网膜中央动脉(CRA,P = 0.02)和视网膜中央静脉(CRV,P<0.001)的收缩期峰值速度显著更高,且与血清ALB值显著相关(CRA;r = 0.41,P = 0.003;CRV;r = 0.60,P<0.001)。
我们认为低血清ALB会增加视盘或其周围血管的通透性,并诱发亚临床视盘水肿,其特征为晚期荧光素染色以及CRA和CRV中的高血流速度。