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糖尿病患者角膜生物力学变化及其对眼压测量的影响。

Corneal biomechanical changes in diabetes mellitus and their influence on intraocular pressure measurements.

作者信息

Sahin Afsun, Bayer Atilla, Ozge Gökhan, Mumcuoğlu Tarkan

机构信息

Eskisehir Osmangazi University Hospital, Eskisehir, Turkey.

出版信息

Invest Ophthalmol Vis Sci. 2009 Oct;50(10):4597-604. doi: 10.1167/iovs.08-2763. Epub 2009 May 14.

DOI:10.1167/iovs.08-2763
PMID:19443722
Abstract

PURPOSE

To investigate possible corneal biomechanical changes in patients with diabetes mellitus and understand the influence of such changes on intraocular pressure measurements.

METHODS

The study group was composed of 120 eyes from 61 healthy control subjects and 81 eyes from 43 diabetic subjects. IOP was measured first with an ocular response analyzer (ORA) and subsequently with a Goldmann applanation tonometer (GAT). Central corneal thickness (CCT) was measured with an ultrasonic pachymeter attached to the ORA. Axial length (AL), anterior chamber depth (ACD), and keratometry readings were acquired with partial coherence laser interferometry during the same visit before all IOP and CCT determinations were made.

RESULTS

Corneal hysteresis (CH) was found to be significantly lower in diabetic patients when compared with healthy control subjects (9.51 +/- 1.82 mm Hg vs. 10.41 +/- 1.66 mm Hg, P < 0.0001). There was no significant difference in terms of corneal resistance factor (CRF; P = 0.8). Mean CCT, GAT IOP, Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were significantly higher in diabetic patients than in healthy control subjects (P = 0.01 for CCT, P < 0.0001 for GAT IOP, IOPg, and IOPcc).

CONCLUSIONS

Diabetes affects corneal biomechanics and results in lower CH values than those in healthy control subjects, which may cause clinically relevant high IOP measurements independent of CCT.

摘要

目的

研究糖尿病患者角膜生物力学可能发生的变化,并了解这些变化对眼压测量的影响。

方法

研究组由61名健康对照者的120只眼和43名糖尿病患者的81只眼组成。首先使用眼反应分析仪(ORA)测量眼压,随后使用Goldmann压平眼压计(GAT)测量。使用连接到ORA的超声角膜厚度仪测量中央角膜厚度(CCT)。在进行所有眼压和CCT测定之前,在同一次就诊期间使用部分相干激光干涉测量法获取眼轴长度(AL)、前房深度(ACD)和角膜曲率读数。

结果

与健康对照者相比,糖尿病患者的角膜滞后(CH)显著降低(9.51±1.82 mmHg对10.41±1.66 mmHg,P<0.0001)。角膜阻力因子(CRF)方面无显著差异(P = 0.8)。糖尿病患者的平均CCT、GAT眼压、Goldmann相关眼压(IOPg)和角膜补偿眼压(IOPcc)显著高于健康对照者(CCT为P = 0.01,GAT眼压、IOPg和IOPcc为P<0.0001)。

结论

糖尿病会影响角膜生物力学,导致CH值低于健康对照者,这可能导致与临床相关的高眼压测量结果,且与CCT无关。

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