Dipartimento di Oncologia Sperimentale e Applicazioni Cliniche, Università degli Studi di Palermo, Italy.
Acta Diabetol. 2010 Sep;47(3):259-63. doi: 10.1007/s00592-010-0193-5. Epub 2010 May 8.
Optical coherence tomography (OCT) has been proven useful in measuring retinal thickness (RT) in patients with diabetes, although with discordant results in different studies. We examined RT in patients with type 1 diabetes (T1D) with or without minimal diabetic retinopathy (MDR) to test whether OCT is able to identify early retinal changes and potential correlations with metabolic parameters. RT of 102 patients with T1D (53 females, 49 males, aged 27.03 +/- 7.4 years) and of 42 healthy controls was examined, with analysis of nine different sectors (fovea, four pericentral and four peripheral sectors). According to the results of basal fundus photography, patients were divided into two groups, without MDR (48 cases) and with MDR (54 cases). Patients with proliferative DR or macular edema were excluded. No difference was found between patients with or without MDR and the control group for all OCT parameters investigated. Mean HbA1c of the last 5 years (P < 0.001), microalbuminuria (P = 0.002), total (P = 0.046) and LDL cholesterol (P = 0.007) and triglyceride (P < 0.001) levels were higher in patients with MDR, along with higher prevalence of hypertension (P = 0.013), younger age at diagnosis (P = 0.018) and longer diabetes duration (P < 0.001) with regard to the patients without MDR and controls, although no significant correlation between these parameters and RT was found. Our study suggests that MDR without macular edema in patients with T1D cannot be detected with OCT. Therefore, the conventional diagnostic methods are mandatory to detect early DR.
光学相干断层扫描(OCT)已被证明可用于测量糖尿病患者的视网膜厚度(RT),尽管不同研究的结果存在差异。我们检查了 102 例 1 型糖尿病(T1D)患者(53 名女性,49 名男性,年龄 27.03 +/- 7.4 岁)和 42 名健康对照者的 RT,分析了 9 个不同的象限(中央凹、4 个近中央象限和 4 个远周边象限)。根据基础眼底摄影的结果,患者分为无最小糖尿病视网膜病变(MDR)组(48 例)和有 MDR 组(54 例)。排除增殖性糖尿病视网膜病变或黄斑水肿患者。无 MDR 患者与有 MDR 患者以及对照组之间,所有 OCT 参数均无差异。最近 5 年的平均 HbA1c(P < 0.001)、微量白蛋白尿(P = 0.002)、总胆固醇(P = 0.046)和 LDL 胆固醇(P = 0.007)和甘油三酯(P < 0.001)水平在有 MDR 的患者中更高,同时高血压(P = 0.013)、更年轻的诊断年龄(P = 0.018)和更长的糖尿病病程(P < 0.001)在有 MDR 患者中更常见,与无 MDR 患者和对照组相比。尽管这些参数与 RT 之间未发现显著相关性。我们的研究表明,在 T1D 患者中,无黄斑水肿的 MDR 不能通过 OCT 检测到。因此,需要常规的诊断方法来检测早期 DR。