Browning David J, Fraser Christina M, Clark Stephen
Charlotte Eye, Ear, Nose, and Throat Associates, PA, Charlotte, North Carolina, USA.
Ophthalmology. 2008 Mar;115(3):533-539.e2. doi: 10.1016/j.ophtha.2007.06.042. Epub 2007 Dec 11.
To examine the relationship of optical coherence tomography (OCT) measured macular thickness to retinopathy severity in patients with diabetes and no clinically detectable macular edema.
Retrospective observational case series.
Three hundred eighty-three eyes of 383 patients of a private retina practice; including 100 normal eyes of patients without diabetes, 100 eyes of diabetics without retinopathy, 100 eyes of diabetics with mild to moderate retinopathy, 35 eyes of diabetics with severe nonproliferative or proliferative retinopathy, and 48 eyes of diabetics with regressed proliferative retinopathy.
Review of clinical charts and optical coherence tomography measurements.
Central subfield mean thickness (CSMT), inner and outer zone measurements, and total macular volume.
Central subfield mean thicknesses (mean +/- standard deviation) were 208+/-22, 198+/-25, 204+/-26, 224+/-38, and 205+/-27 microm for normals, eyes of diabetics without retinopathy, eyes with mild to moderate nonproliferative retinopathy, eyes with severe nonproliferative to proliferative retinopathy, and eyes with regressed proliferative retinopathy, respectively. For all groups, mean CSMT was larger in males than in females. Statistically significant differences by gender were observed for normals, diabetics without retinopathy, and diabetics with mild to moderate nonproliferative retinopathy (mean differences, 12, 14, and 18 microm, respectively; Ps = 0.0057, 0.0057, and 0.0002). For increasing retinopathy severity, the probability of macular thickening detected by OCT but not detected by clinical examination increased. Fifteen percent of eyes with severe nonproliferative or proliferative retinopathy and no clinically detected edema had OCT-measured macular thickening.
Because OCT measurements are gender dependent, gender balance or statistical adjustment for gender imbalances of compared groups in OCT studies of diabetic macular edema is important. As retinopathy severity increases, the probability of subclinical edema rises. Except for an individual baseline measurement possibly useful for longitudinal comparison, the data suggest that there is little reason routinely to obtain OCT in eyes with diabetes and no retinopathy or mild to moderate diabetic retinopathy when clinical examination fails to show macular edema.
研究光学相干断层扫描（OCT）测量的黄斑厚度与无临床可检测黄斑水肿的糖尿病患者视网膜病变严重程度之间的关系。
回顾性观察病例系列。
一家私人视网膜诊所的383例患者的383只眼；包括100例无糖尿病患者的正常眼、100例无视网膜病变的糖尿病患者的眼、100例轻度至中度视网膜病变的糖尿病患者的眼、35例重度非增殖性或增殖性视网膜病变的糖尿病患者的眼以及48例增殖性视网膜病变已消退的糖尿病患者的眼。
回顾临床病历和光学相干断层扫描测量结果。
中心子野平均厚度（CSMT）、内区和外区测量值以及黄斑总体积。
正常眼、无视网膜病变的糖尿病患者的眼、轻度至中度非增殖性视网膜病变的眼、重度非增殖性至增殖性视网膜病变的眼以及增殖性视网膜病变已消退的糖尿病患者的眼的中心子野平均厚度（均值±标准差）分别为208±22、198±25、204±26、224±38和205±27微米。在所有组中，男性的平均CSMT均大于女性。在正常眼、无视网膜病变的糖尿病患者以及轻度至中度非增殖性视网膜病变的糖尿病患者中观察到了性别差异具有统计学意义（平均差异分别为12、14和18微米；P值分别为0.0057、0.0057和0.0002）。随着视网膜病变严重程度的增加，OCT检测到但临床检查未检测到的黄斑增厚的可能性增加。15%的重度非增殖性或增殖性视网膜病变且无临床检测到水肿的眼有OCT测量的黄斑增厚。
由于OCT测量结果与性别有关，在糖尿病性黄斑水肿的OCT研究中，对比组的性别平衡或对性别失衡进行统计调整很重要。随着视网膜病变严重程度的增加，亚临床水肿的可能性增加。除了可能有助于纵向比较的个体基线测量值外，数据表明，当临床检查未显示黄斑水肿时，对于无视网膜病变或轻度至中度糖尿病性视网膜病变的糖尿病患者的眼，没有什么理由常规进行OCT检查。
