Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17 Street, Miami, Fl 33136, USA.
Med Sci Monit. 2010 Mar;16(3):MT15-21.
Diabetic Retinopathy (DR) is a severe and widely spread eye disease. Thus, an objective test for the early diagnosis and evaluation of treatment in DR is certainly needed. In this study, the ability of intraretinal layer segmentation to locally detect early retinal changes in diabetic patients is assessed using optical coherence tomography (OCT).
MATERIAL/METHODS: Fifty diabetic patients with no or minimal DR underwent ophthalmic examination, OCT and fundus photography. Automated segmentation of intraretinal layers of the OCT images was performed using a custom-built algorithm. Mean thickness of the macula and intraretinal layers of patients with no DR (DM) was calculated in the fovea, pericentral and peripheral regions and compared with those in patients with mild DR (MDR).
We found reduced retinal nerve fiber layer (RNFL) thickness in the pericentral and peripheral regions (27 + or - 2 versus 18 + or - 5 microm and 42 + or - 3 versus 33 + or - 9 microm, respectively, p<0.001) and reduced thickness of ganglion cell/inner plexiform layer (GCL+IPL) complex in the pericentral region of the macula (92 + or - 7 microm versus 80 + or - 10 microm, p<0.001) in the MDR group. Accordingly, macular thickness was reduced in the pericentral and peripheral region of the macula in the MDR group.
Our results support the view of neurodegeneration in diabetes in the early stage of retinopathy which seems to involve the ganglion cells and cells of the inner plexiform layers (RNFL+GCL+IPL) mostly. Local retinal thickness measures can be obtained from OCT scans using an intraretinal layer segmentation procedure, and these measures could be helpful in finding a surrogate for following development of retinopathy that could affect vision.
糖尿病视网膜病变（DR）是一种严重且广泛传播的眼部疾病。因此，需要一种客观的测试方法来对 DR 进行早期诊断和治疗评估。在这项研究中，我们使用光学相干断层扫描（OCT）评估视网膜内部分层分割对糖尿病患者早期视网膜变化的检测能力。
材料/方法：50 名无或轻度 DR 的糖尿病患者接受了眼科检查、OCT 和眼底照相。使用定制的算法对 OCT 图像的视网膜内部分层进行自动分割。无 DR（DM）患者的黄斑和视网膜内各层的平均厚度在中央凹、中心旁和周边区域进行计算，并与轻度 DR（MDR）患者进行比较。
我们发现，在中心旁和周边区域，视网膜神经纤维层（RNFL）厚度变薄（分别为 27 + or - 2μm 和 42 + or - 3μm，与 18 + or - 5μm 和 33 + or - 9μm 相比，p<0.001），黄斑中心旁区域的节细胞/内丛状层（GCL+IPL）复合体厚度变薄（92 + or - 7μm 与 80 + or - 10μm 相比，p<0.001）。因此，MDR 组黄斑中心旁和周边区域的黄斑厚度变薄。
我们的结果支持在 DR 早期阶段发生神经退行性病变的观点，该病变似乎主要累及节细胞和内丛状层细胞（RNFL+GCL+IPL）。使用视网膜内部分层分割程序，可以从 OCT 扫描中获得局部视网膜厚度测量值，这些测量值可能有助于发现影响视力的 DR 进展的替代指标。
