Li Hai-Yan, Luo Guo-Chun, Guo Jiang, Liang Zhen
Department of Endocrinology, the Second People's Hospital of Shenzhen, Shenzhen 518035, Guangdong Province, China.
Int J Ophthalmol. 2010;3(2):158-60. doi: 10.3980/j.issn.2222-3959.2010.02.15. Epub 2010 Jun 18.
To evaluate the effects of glycemic control on refraction in diabetic patients.
Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control.
A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length.
Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.
评估血糖控制对糖尿病患者屈光的影响。
本研究纳入20例新诊断的糖尿病患者。治疗前测量随机血糖、糖化血红蛋白（HbA1c）水平、空腹C肽和餐后2小时C肽。选取随机血糖高于12.0mmol/L且HbA1c水平高于10.0%的患者。在血糖控制期间，于入院时以及第1、2、3和4周结束时测量屈光、眼压、角膜前表面曲率半径、前房深度、晶状体厚度、玻璃体长度和眼轴长度。
所有接受血糖控制的患者均出现短暂性远视改变。最大远视改变为1.60D（范围0.50±3.20D）。胰岛素治疗后2至4周恢复至先前的屈光状态。最大远视改变与入院时的HbA1c水平呈正相关（r=0.84，P<0.05）。最大远视改变与治疗前7天的每日血糖降低率呈正相关（r=0.53，P<0.05）。在短暂性远视期间，眼压、角膜前表面曲率半径、前房深度、晶状体厚度、玻璃体长度和眼轴长度未观察到显著变化。
血糖控制后，重度高血糖的糖尿病患者会出现短暂性远视改变。短暂性远视的程度高度依赖于治疗前的HbA1c水平和血糖水平的降低率。
