Schmid Katharina E, Neumaier-Ammerer Beatrix, Stolba Ulrike, Binder Susanne
Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic Vienna, Vienna, Austria.
Graefes Arch Clin Exp Ophthalmol. 2006 Nov;244(11):1446-52. doi: 10.1007/s00417-006-0322-6. Epub 2006 Apr 7.
Glycosylated haemoglobin (HbA1c) correlates with the amount of hyperglycemia in diabetic patients. High HbA1c levels often predict clinically significant macular edema (CSME), which then needs to be treated with grid laser photocoagulation. The question asked in this study was whether there is a correlation between the effect grid laser photocoagulation in diffuse diabetic macular edema and HbA1c, using an optical coherence tomography (OCT) for the evaluation of the retinal thickness.
A prospective, non-comparative case series was performed to find a correlation between the effect of grid laser photocoagulation in diffuse diabetic macular edema and HbA1c. Thirty eyes with CSME of diabetic patients were included in the study. Complete ophthalmic examinations and OCT were performed at baseline, 1 month, 3, and 6 months after grid laser photocoagulation therapy. HbA1c was measured at the end of study.
Significance level was set at P<0.05. A significant difference in the foveal (P=0.02) and superior (P=0.021) retinal thickness 6 months after laser therapy, no correlation between HbA1c and retinal thickness after photocoagulation, and an insignificant decrease in visual acuity (P=0.9) were found. The correlation between foveal retinal thickness and visual acuity was P=0.24 6 months after treatment.
There was no significant correlation between HbA1c and the effect of grid laser photocoagulation therapy in diffuse diabetic macular edema. The retinal thickness decreased significantly in the foveal and superior area 6 months after therapy. No correlation between the foveal retinal thickness and the visual acuity was found. The visual acuity did not increase after treatment. There are many factors influencing the retinal thickness, such as the blood pressure and the attached posterior hyaloid.
糖化血红蛋白（HbA1c）与糖尿病患者的高血糖水平相关。高HbA1c水平常预示临床上显著的黄斑水肿（CSME），进而需要采用格栅激光光凝治疗。本研究探讨的问题是，对于弥漫性糖尿病性黄斑水肿，使用光学相干断层扫描（OCT）评估视网膜厚度时，格栅激光光凝的疗效与HbA1c之间是否存在相关性。
开展一项前瞻性、非对照病例系列研究，以探寻弥漫性糖尿病性黄斑水肿中格栅激光光凝的疗效与HbA1c之间的相关性。研究纳入30例糖尿病性CSME患者的患眼。在格栅激光光凝治疗前、治疗后1个月、3个月和6个月进行全面的眼科检查及OCT检查。在研究结束时测量HbA1c。
显著性水平设定为P<0.05。激光治疗6个月后，黄斑区（P=0.02）和上方（P=0.021）视网膜厚度有显著差异，光凝后HbA1c与视网膜厚度之间无相关性，视力有不显著下降（P=0.9）。治疗6个月后，黄斑区视网膜厚度与视力之间的相关性为P=0.24。
在弥漫性糖尿病性黄斑水肿中，HbA1c与格栅激光光凝治疗的疗效之间无显著相关性。治疗6个月后，黄斑区和上方区域的视网膜厚度显著降低。未发现黄斑区视网膜厚度与视力之间存在相关性。治疗后视力未提高。影响视网膜厚度的因素众多，如血压和玻璃体后皮质附着情况等。
