Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Invest Ophthalmol Vis Sci. 2010 Dec;51(12):6710-4. doi: 10.1167/iovs.09-5064. Epub 2010 May 19.
The aim of this study was to correlate different types of retinal morphologic alterations secondary to diabetic macular disease with their characteristic impact on retinal function.
In the present cross-sectional study, 26 eyes of 26 diabetic patients with clinically significant macular edema were examined. All patients underwent complete standardized ophthalmologic examination, including SD-OCT and microperimetry. Microperimetric values were projected over the scanning laser ophthalmoscope image of the OCT device, allowing direct correlation of functional and morphologic parameters. Results over all 1066 individual areas were analyzed using a general linear model.
All the characteristic morphologic alterations demonstrated a significant effect on retinal function (P < 0.0002), except for outer nuclear layer (ONL) hyporeflectivity and small ONL cysts. Large ONL cysts (>220 μm) and serous retinal detachment had the greatest estimated negative effect on retinal sensitivity (-3.86 and -3.66 dB), followed by medium-sized ONL cysts, hard exudates associated with an extinction of the scan signal, and inner nuclear layer cysts.
In diabetic macular edema, serous retinal detachment and large ONL cysts are the two morphologic changes with the greatest negative impact on retinal function.
本研究旨在探讨糖尿病性黄斑病变导致的不同类型视网膜形态改变与其对视网膜功能的特征性影响之间的相关性。
本横断面研究纳入了 26 例糖尿病伴临床显著黄斑水肿患者的 26 只眼。所有患者均接受了全面的标准化眼科检查，包括 SD-OCT 和微视野计检查。微视野计的测量值投射到 OCT 设备的扫描激光检眼镜图像上，从而可以直接对功能和形态参数进行相关性分析。使用一般线性模型对所有 1066 个个体区域的结果进行分析。
除了外核层（ONL）低反射和小 ONL 囊肿外，所有特征性的形态改变均对视网膜功能有显著影响（P<0.0002）。大 ONL 囊肿（>220μm）和浆液性视网膜脱离对视网膜敏感性的估计负面影响最大（分别为-3.86 和-3.66dB），其次是中等大小的 ONL 囊肿、伴有扫描信号消失的硬性渗出物以及内核层囊肿。
在糖尿病性黄斑水肿中，浆液性视网膜脱离和大 ONL 囊肿是对视网膜功能有最大负面影响的两种形态改变。
