Shukla Dhananjay, Kolluru Chandra Mohan, Singh Jatinder, John Rajesh K, Soman Manoj, Gandhi Banushree, Kim R, Perumalsamy Namperumalsamy
Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, 1 Anna Nagar, Madurai 625 020, Tamil Nadu, India.
Indian J Ophthalmol. 2004 Sep;52(3):205-10.
To determine whether diabetic macular ischaemia is associated with ischaemic heart disease (IHD), hyperlipidaemia, hypertension (HTN) and nephropathy.
Prospective case-control study from January to December 2001, involving 102 type 2 diabetic patients (aged 40-80 years), 59 with unilateral / bilateral macular ischaemia and 43 concurrent controls. Diabetic retinopathy was graded and macular ischaemia assessed by fundus examination, central fundus photography and fluorescein angiography. Systemic examination and laboratory investigations were done to evaluate systemic diseases. The associations were analysed by Chi-square test and Student's t-test. The significance of the variables as independent risk factors was tested by logistic regression analysis.
Macular ischaemia was not associated with IHD (P=1.00); HTN (P=1.00) and hyperlipidaemia (P=0.30). Nephropathy was significantly associated with macular ischaemia (P=0.025; odds ratio [OR]: 2.62; 95% confidence interval [CI]: 1.16-5.9). The association remained significant after controlling for age, gender, duration of diabetes, severity of retinopathy, HTN, IHD and hyperlipidaemia. Further, the association with nephropathy was not affected by the presence of macular isachaemia in one or both the eyes (P=0.39).
Macular ischaemia may serve as a marker for nephropathy in type 2 diabetes mellitus irrespective of the severity of retinopathy.
确定糖尿病性黄斑缺血是否与缺血性心脏病（IHD）、高脂血症、高血压（HTN）及肾病相关。
2001年1月至12月进行的前瞻性病例对照研究，纳入102例2型糖尿病患者（年龄40 - 80岁），其中59例有单侧/双侧黄斑缺血，43例为同期对照。通过眼底检查、眼底中央摄影及荧光素血管造影对糖尿病视网膜病变进行分级并评估黄斑缺血情况。进行系统检查及实验室检测以评估全身性疾病。采用卡方检验和学生t检验分析相关性。通过逻辑回归分析检验各变量作为独立危险因素的显著性。
黄斑缺血与缺血性心脏病（P = 1.00）、高血压（P = 1.00）及高脂血症（P = 0.30）无关。肾病与黄斑缺血显著相关（P = 0.025；比值比[OR]：2.62；95%置信区间[CI]：1.16 - 5.9）。在控制年龄、性别、糖尿病病程、视网膜病变严重程度、高血压、缺血性心脏病及高脂血症后，该相关性依然显著。此外，肾病与黄斑缺血的相关性不受单眼或双眼黄斑缺血存在情况的影响（P = 0.39）。
无论视网膜病变严重程度如何，黄斑缺血可能是2型糖尿病肾病的一个标志物。
