Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Invest Ophthalmol Vis Sci. 2012 Mar 21;53(3):1506-11. doi: 10.1167/iovs.11-9231.
To investigate the relationship between the cystoid spaces in the outer plexiform layer (OPL) and the characteristics of the photoreceptors beneath the cystoid spaces in patients with diabetic macular edema (DME).
In this observational cross-sectional study, 123 eyes of 96 consecutive patients with clinically significant macular edema were retrospectively reviewed. The characteristics of the photoreceptors on optical coherence tomography (OCT) images represented by the external limiting membrane (ELM) and the junction between inner and outer segments (IS/OS), and their association with the overlying cystoid spaces were investigated.
The areas beneath the cystoid spaces in the OPL had a longer transverse length of disrupted or faint IS/OS and disrupted ELM lines than those without cystoid spaces (P < 0.001, P < 0.001, and P = 0.009). The IS/OS lines beneath the cystoid spaces had higher reflectivity than those in areas without cystoid spaces (P < 0.001). Enlarged cystoid spaces extending from the inner nuclear layer to the OPL were associated with disrupted IS/OS or ELM but not faint IS/OS (P < 0.001, P < 0.001, and P = 0.467). The transverse length of disrupted IS/OS at the fovea was correlated with the logarithm of the minimum angle of resolution (logMAR) more than the association between foveal thickness and logMAR (r = 0.49, P < 0.001 vs. r = 0.28, P = 0.002). The ELM descended to the RPE more frequently in eyes with single-lobulated fluorescein pooling in the foveal avascular zone than those with multi-lobulated pooling (P < 0.001).
OCT showed that the cystoid spaces in the OPL were accompanied by photoreceptor damage beneath the cystoid spaces in DME.
研究糖尿病性黄斑水肿（DME）患者外丛状层（OPL）中的囊样间隙与囊下光感受器特征之间的关系。
在这项回顾性的观察性横断面研究中，共分析了 96 例 123 只临床显著黄斑水肿患者的眼部情况。通过光学相干断层扫描（OCT）图像中的外节膜（ELM）和内节与外节交界处（IS/OS）来代表光感受器的特征，并对其与上方囊样间隙的关系进行研究。
OPL 中囊样间隙下方区域的 IS/OS 中断或模糊线和 ELM 线的横向长度长于无囊样间隙区域（P<0.001，P<0.001，和 P=0.009）。囊样间隙下方的 IS/OS 线比无囊样间隙区域的反射率更高（P<0.001）。从内核层延伸到 OPL 的扩大囊样间隙与 IS/OS 或 ELM 中断有关，但与 IS/OS 模糊无关（P<0.001，P<0.001，和 P=0.467）。黄斑中心凹处 IS/OS 中断的横向长度与最小角分辨率（logMAR）的对数呈正相关，而与黄斑中心凹厚度和 logMAR 之间的关系更为密切（r=0.49，P<0.001 比 r=0.28，P=0.002）。在中心凹无血管区出现单叶状荧光素积聚的眼中，ELM 更常下降到 RPE，而在多叶状积聚的眼中则较少见（P<0.001）。
OCT 显示，DME 患者 OPL 中的囊样间隙伴有囊下光感受器损伤。
