Sakata Kumi, Funatsu Hideharu, Harino Seiyo, Noma Hidetaka, Hori Sadao
Department of Ophthalmology, Tokyo Women's Medical University, Tokyo, Japan.
Ophthalmology. 2007 Nov;114(11):2061-9. doi: 10.1016/j.ophtha.2007.01.003. Epub 2007 Apr 18.
To assess perifoveal capillary blood flow velocity (BFV), capillary occlusion, and retinal thickness at the central fovea in diabetic patients with or without clinically significant macular edema; to examine the relationships of these variables with visual acuity (VA); and to identify their contributions to visual outcome and diabetic macular edema.
Comparative cross-sectional prospective study.
Diabetic patients with clinically significant macular edema (CSME) (n = 22), matched diabetic patients without CSME (n = 22), and healthy volunteers (n = 16).
Capillary BFV was measured by fluorescein angiography using a scanning laser ophthalmoscope and was analyzed by the tracing method. Severity of perifoveal capillary abnormalities was classified by the size and outline of the foveal avascular zone (FAZ) and extent of foveal capillary loss. Macular thickness was measured by optical coherence tomography. Each subject underwent a complete ophthalmic evaluation, and best-corrected VA (BCVA) was converted to the logarithm of the minimum angle of resolution scale.
Relationship of perifoveal capillary BFV, capillary occlusion, and foveal thickness with VA.
Best-corrected VA significantly differed among all 3 groups (P<0.0001). Best-corrected VA correlated negatively with BFV (r = -0.644, P<0.0001) among all subjects and positively with retinal thickness at the central fovea in diabetic patients with CSME (r = 0.640, P = 0.0013). There was a positive correlation between BCVA and severity in the size of the FAZ (r = 0.484, P = 0.0015), outline of the FAZ (r = 0.542, P = 0.0004), and extent of foveal capillary loss (r = 0.585, P = 0.0001) among all diabetic subjects. Multiple regression analysis showed that retinal thickness at the central fovea was the only variable that significantly predicted VA (standardized regression coefficient, 0.635; P = 0.0001).
Best-corrected VA was associated with perifoveal capillary BFV, severity of perifoveal capillary occlusion, and retinal thickness at the central fovea in diabetic patients, but the greatest contributing factor was only the retinal thickness.
评估伴有或不伴有临床显著性黄斑水肿的糖尿病患者的中心凹周围毛细血管血流速度（BFV）、毛细血管闭塞情况以及中心凹处的视网膜厚度；研究这些变量与视力（VA）之间的关系；并确定它们对视力结果和糖尿病性黄斑水肿的影响。
比较性横断面前瞻性研究。
患有临床显著性黄斑水肿（CSME）的糖尿病患者（n = 22）、匹配的无CSME的糖尿病患者（n = 22）以及健康志愿者（n = 16）。
使用扫描激光检眼镜通过荧光素血管造影测量毛细血管BFV，并采用追踪法进行分析。根据中心凹无血管区（FAZ）的大小和轮廓以及中心凹毛细血管缺失程度对中心凹周围毛细血管异常的严重程度进行分类。通过光学相干断层扫描测量黄斑厚度。每位受试者均接受全面的眼科评估，并将最佳矫正视力（BCVA）转换为最小分辨角对数视力表。
中心凹周围毛细血管BFV、毛细血管闭塞情况以及中心凹厚度与VA之间的关系。
所有3组之间的最佳矫正视力存在显著差异（P<0.0001）。在所有受试者中，最佳矫正视力与BFV呈负相关（r = -0.644，P<0.0001），在患有CSME的糖尿病患者中，最佳矫正视力与中心凹处的视网膜厚度呈正相关（r = 0.640，P = 0.0013）。在所有糖尿病受试者中，BCVA与FAZ大小的严重程度（r = 0.484，P = 0.0015）、FAZ轮廓（r = 0.542，P = 0.0004）以及中心凹毛细血管缺失程度（r = 0.585，P = 0.0001）之间存在正相关。多元回归分析表明，中心凹处的视网膜厚度是唯一能显著预测视力的变量（标准化回归系数，0.635；P = 0.0001）。
在糖尿病患者中，最佳矫正视力与中心凹周围毛细血管BFV、中心凹周围毛细血管闭塞严重程度以及中心凹处的视网膜厚度有关，但最大的影响因素仅是视网膜厚度。
