Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Ophthalmology. 2013 Oct;120(10):2023-8. doi: 10.1016/j.ophtha.2013.03.009. Epub 2013 May 19.
To examine subfoveal choroidal thickness (SFCT) in patients with diabetes mellitus and patients with diabetic retinopathy.
Population-based, cross-sectional study.
The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 ± 9.8 years (range, 50-93 years).
A detailed ophthalmic examination was performed including spectral-domain optical coherence tomography (OCT) with enhanced depth imaging for measurement of SFCT and fundus photography for the assessment of diabetic retinopathy.
Subfoveal choroidal thickness.
Fasting blood samples, fundus photographs, and choroidal OCT images were available for 2041 subjects (58.8%), with 246 subjects (12.1 ± 0.7%) fulfilling the diagnosis of diabetes mellitus and 23 subjects having diabetic retinopathy. Mean SFCT did not differ significantly between patients with diabetes mellitus and nondiabetic subjects (266 ± 108 vs. 261 ± 103 μm; P=0.43) nor between patients with diabetic retinopathy and subjects without retinopathy (249 ± 86 vs. 262 ± 104 μm; P = 0.56). After adjustment for age, sex, axial length, lens thickness, anterior chamber depth, corneal curvature radius, and best-corrected visual acuity, SFCT was associated with a higher glycosylated hemoglobin (HbA1c) value (P<0.001; regression coefficient B, 8.18; 95% confidence interval [CI], 4.02-12.3); standardized coefficient β, 0.08) or with the presence of diabetes mellitus (P = 0.001; B, 21.3; 95% CI, 9.12-33.5) but not with presence of diabetic retinopathy (P = 0.61) or stage of diabetic retinopathy (P = 0.14). As a corollary, after adjusting for age, region of habitation, body mass index, systolic and diastolic blood pressure, and level of education, diabetes mellitus was associated with a thicker SFCT (P<0.001). In contrast, neither presence of diabetic retinopathy (P = 0.61) nor stage of diabetic retinopathy (P = 0.09) were associated significantly with SFCT after adjusting for body mass index, diastolic and systolic blood pressure, and level of education and after adjusting for blood glucose concentrations, HbA1c value, diagnosis of diabetes mellitus, and systolic and diastolic blood pressure, respectively.
Patients with diabetes mellitus had a slightly, but statistically significantly, thicker subfoveal choroid, whereas presence and stage of diabetic retinopathy were not associated additionally with an abnormal SFCT. Whereas diabetes mellitus as a systemic disease leads to a slight thickening of the choroid, diabetic retinopathy as an ocular disorder was not associated with choroidal thickness abnormalities after adjusting for the presence of diabetes mellitus.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
研究糖尿病患者和糖尿病视网膜病变患者的黄斑下脉络膜厚度（SFCT）。
基于人群的横断面研究。
基于人群的北京眼研究 2011 年纳入了 3468 名平均年龄为 64.6±9.8 岁（范围，50-93 岁）的个体。
进行了详细的眼科检查，包括用于测量 SFCT 的频域光相干断层扫描（OCT）和增强深度成像以及用于评估糖尿病视网膜病变的眼底照相。
黄斑下脉络膜厚度。
有 2041 名受试者（58.8%）可提供空腹血样、眼底照片和脉络膜 OCT 图像，其中 246 名受试者（12.1±0.7%）符合糖尿病诊断，23 名受试者患有糖尿病视网膜病变。糖尿病患者与非糖尿病患者的 SFCT 无显著差异（266±108 与 261±103μm；P=0.43），也与无视网膜病变的患者无差异（249±86 与 262±104μm；P=0.56）。在校正年龄、性别、眼轴长度、晶状体厚度、前房深度、角膜曲率半径和最佳矫正视力后，SFCT 与较高的糖化血红蛋白（HbA1c）值相关（P<0.001；回归系数 B，8.18；95%置信区间[CI]，4.02-12.3；标准化系数β，0.08）或与糖尿病有关（P=0.001；B，21.3；95%CI，9.12-33.5），但与糖尿病视网膜病变的存在（P=0.61）或糖尿病视网膜病变的分期（P=0.14）无关。作为推论，在校正年龄、居住地区、体重指数、收缩压和舒张压以及教育程度后，糖尿病与 SFCT 增厚显著相关（P<0.001）。相比之下，在校正体重指数、舒张压和收缩压以及教育程度后，糖尿病视网膜病变的存在（P=0.61）或糖尿病视网膜病变的分期（P=0.09）与 SFCT 均无显著相关性，在校正血糖浓度、HbA1c 值、糖尿病诊断、收缩压和舒张压后也无相关性。
糖尿病患者的黄斑下脉络膜厚度略有但统计学上显著增厚，而糖尿病视网膜病变的存在和分期则与异常的 SFCT 无额外关联。糖尿病作为一种全身性疾病导致脉络膜轻微增厚，而糖尿病视网膜病变作为一种眼部疾病，在校正糖尿病存在的情况下，与脉络膜厚度异常无关。
作者在本文讨论的材料中没有任何专有的或商业的利益。
