Torrón-Fernández-Blanco C, Ruiz-Moreno O, Ferrer-Novella E, Sánchez-Cano A, Honrubia-López F M
Servicio de Oftalmología, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Arch Soc Esp Oftalmol. 2006 Mar;81(3):147-53. doi: 10.4321/s0365-66912006000300006.
To determine the incidence of cystoid macular edema (CME) by means of clinical evaluation and subclinical assessment by means of ocular coherence tomography (OCT), and to compare the incidence between diabetic and non-diabetic groups of patients.
Prospective study of 260 consecutive cataract surgeries operated from September 2004 to March 2005. The procedures were performed by means of phacoemulsification plus intraocular acrylic lens implantation. Group A: 208 eyes of non-diabetic patients; Group B: 42 eyes of patients with diabetes and Group C: 10 eyes of diabetic patients with macular edema that received an intravitreal injection of triamcinolone at the end of surgery. Postoperative follow-up visits were performed 6 days (basal visit), 5 weeks and 12 weeks after surgery. Each visit included posterior pole biomicroscopy and OCT.
Central macular thickness measured by OCT was significantly increased in group B compared with group A (241.6 versus 204.6 microm; p<0.001). No clinical evidence of CME was found in group A, although 4 eyes (1.92%) showed macular thickness equal to or greater than 43.74 microm (2 standard deviations of the basal value for group A). In group B, clinical evidence of CME was found in 6 eyes, with decreased visual acuities (14.2%). The differences between these groups were statistically significant (p<0.001). The 10 eyes that received an intravitreal injection of triamcinolone after the surgical procedure showed a mean decrease in central retinal thickness of 77 microm after 12 weeks postoperative.
This study has shown a low incidence of clinical CME. OCT showed increased macular thickness in both groups of patients in a small percentage of cases, and significantly increased macular thickness in diabetic patients.
通过临床评估及光学相干断层扫描(OCT)进行亚临床评估来确定黄斑囊样水肿(CME)的发生率,并比较糖尿病患者组与非糖尿病患者组之间的发生率。
对2004年9月至2005年3月连续进行的260例白内障手术进行前瞻性研究。手术采用超声乳化联合眼内丙烯酸人工晶状体植入术。A组:208只非糖尿病患者的眼睛;B组:42只糖尿病患者的眼睛;C组:10只患有黄斑水肿的糖尿病患者的眼睛,在手术结束时接受了玻璃体内注射曲安奈德。术后分别在术后6天(基础访视)、5周和12周进行随访。每次访视包括后极部生物显微镜检查和OCT检查。
与A组相比,B组经OCT测量的中心黄斑厚度显著增加(241.6微米对204.6微米;p<0.001)。A组未发现CME的临床证据,尽管有4只眼睛(1.92%)的黄斑厚度等于或大于43.74微米(A组基础值的2个标准差)。在B组中,6只眼睛发现了CME的临床证据,视力下降(14.2%)。这些组之间的差异具有统计学意义(p<0.001)。手术后接受玻璃体内注射曲安奈德的10只眼睛在术后12周时中心视网膜厚度平均下降了77微米。
本研究显示临床CME的发生率较低。OCT显示两组患者中均有一小部分病例黄斑厚度增加,且糖尿病患者黄斑厚度显著增加。