光学相干断层扫描用于检测糖尿病视网膜病变患者的早期黄斑水肿。

Optical coherence tomography for the detection of early macular edema in diabetic patients with retinopathy.

作者信息

Koleva-Georgieva Desislava N, Sivkova Nelly P

机构信息

Department of Ophtalmology, St. George University Hospital, Medical University, Plovdiv, Bulgaria.

出版信息

Folia Med (Plovdiv). 2010 Jan-Mar;52(1):40-8.

PMID:20380286

Abstract

AIM

To compare the retinal thickness measurements with spectral-domain optical coherence tomography (OCT) in healthy subjects with those of type 2 diabetes patients with or without diabetic retinopathy (DR) and with no clinical evidence of diabetic macular edema (DME).

PATIENTS AND METHODS

The present prospective study included 29 diabetic patients (57 eyes) with no DR (group 1), 32 diabetic patients (63 eyes) with DR (group 2) and 25 healthy volunteers (39 eyes, control group). Eyes showing macular edema on slit-lamp biomicroscopy or leakage on fluorescein angiography were not included in the study. The mean retinal thickness at the central fixation point (CFP) and the 9 ETDRS macular regions were compared in subgroups of healthy volunteers by age, sex and right or left eye. These mean retinal thickness values were also compared in the control group, group 1 and group 2. Early DME was diagnosed with OCT if it exceeded the mean thickness +2.SD (standard deviation) in healthy subjects.

RESULTS

Mean retinal thickness at the CFP and fovea in healthy eyes was 176 +/- 16.8 microm and 198.3 +/- 21.4 microm, respectively. It was significantly greater in men than in women (p < 0.05), decreased with age and showed no statistically significant difference between right and left eyes. Differences in retinal thickness were found to be significant for the CFP and all ETDRS regions (controls vs. group 1 and controls vs. group 2) and for the CFP, fovea, superior inner, temporal inner and nasal inner ETDRS regions (group 1 vs. group 2, group 2 having greater thickness). Early DME was diagnosed at retinal thickness exceeding 209.6 microm at the CFP and 241.1 microm at the fovea in 13 eyes of diabetic patients from group 2. Twelve eyes with early DME had mild non-proliferative DR and one--moderate non-proliferative DR.

CONCLUSION

In the present study, mean retinal thickness was greater in diabetic patients (with and without DR) than in healthy subjects. Patients with DR had thicker retinas than patients without DR. Spectral-domain OCT seemed to be useful for the detection of early DME in patients with retinopathy and no clinical evidence of macular edema. Patients with early DME should have a closer follow-up

摘要

目的

比较健康受试者、患有或未患有糖尿病视网膜病变（DR）且无糖尿病性黄斑水肿（DME）临床证据的2型糖尿病患者的视网膜厚度测量值与光谱域光学相干断层扫描（OCT）测量值。

患者与方法

本前瞻性研究纳入了29例无DR的糖尿病患者（57只眼）（第1组）、32例患有DR的糖尿病患者（63只眼）（第2组）和25名健康志愿者（39只眼，对照组）。裂隙灯生物显微镜检查显示黄斑水肿或荧光素血管造影显示渗漏的眼睛未纳入本研究。按年龄、性别和右眼或左眼对健康志愿者亚组的中央注视点（CFP）和9个ETDRS黄斑区域的平均视网膜厚度进行比较。还对对照组、第1组和第2组的这些平均视网膜厚度值进行了比较。如果早期DME超过健康受试者的平均厚度+2个标准差（SD），则通过OCT进行诊断。

结果

健康眼睛的CFP和黄斑中心凹处的平均视网膜厚度分别为176±16.8微米和198.3±21.4微米。男性的平均视网膜厚度显著大于女性（p<0.05），随年龄增长而降低，右眼和左眼之间无统计学显著差异。发现CFP和所有ETDRS区域（对照组与第1组以及对照组与第2组）以及CFP、黄斑中心凹、鼻侧内上、颞侧内和鼻侧内ETDRS区域（第1组与第2组，第2组厚度更大）的视网膜厚度差异具有统计学意义。在第2组的13只糖尿病患者眼中，当CFP处视网膜厚度超过209.6微米且黄斑中心凹处超过241.1微米时诊断为早期DME。12只患有早期DME的眼睛患有轻度非增殖性DR，1只患有中度非增殖性DR。