Second Department of Ophthalmology, University of Athens, Athens, Greece. patheo @ med.uoa.gr
Ophthalmologica. 2012;227(2):90-4. doi: 10.1159/000331321. Epub 2011 Sep 15.
BACKGROUND/AIMS: To evaluate changes in macular thickness measured by optical coherence tomography (OCT) during a hemodialysis (HD) session in diabetic patients with end-stage renal disease.
72 eyes of 36 diabetic patients with and without macular edema were evaluated before and immediately after an HD session. Average and maximum macular thicknesses in the central disk (6 mm in diameter) and total macular volume were measured.
In the eyes with diabetic macular edema, maximum macular thickness within the central disk of 6 mm, and mainly in its peripheral parts, was significantly reduced by 31.18 ± 4.18 μm after HD (p < 0.001). Average macular thickness and total macular volume were also significantly reduced (p = 0.003 and 0.015, respectively). In diabetic eyes without edema, maximum macular thickness decreased significantly by 11.21 ± 1.98 μm after HD (p < 0.001), while average macular thickness and total macular volume decreased slightly (p = 0.034, p = 0.043). Best-corrected visual acuity failed to change. We found a significant association of macular thickness changes with osmolality reduction and the presence of macular edema.
HD decreases macular thickness in diabetic patients with macular edema, while there exists a less-pronounced effect in diabetic eyes without edema.
背景/目的：评估终末期肾病糖尿病患者血液透析（HD）过程中光学相干断层扫描（OCT）测量的黄斑厚度变化。
评估了 36 例糖尿病患者 72 只眼（伴或不伴黄斑水肿）在 HD 前后的情况。测量了直径为 6mm 的中央盘内平均和最大黄斑厚度以及总黄斑体积。
在伴有糖尿病性黄斑水肿的眼中，6mm 中央盘内的最大黄斑厚度，主要是其周边部分，在 HD 后显著降低了 31.18±4.18μm（p<0.001）。平均黄斑厚度和总黄斑体积也显著降低（p=0.003 和 0.015）。在无黄斑水肿的糖尿病眼中，最大黄斑厚度在 HD 后显著降低了 11.21±1.98μm（p<0.001），而平均黄斑厚度和总黄斑体积略有降低（p=0.034，p=0.043）。最佳矫正视力没有变化。我们发现黄斑厚度变化与渗透压降低和黄斑水肿的存在有显著相关性。
HD 降低了伴有黄斑水肿的糖尿病患者的黄斑厚度，而在无黄斑水肿的糖尿病眼中则存在不太明显的影响。
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