Santiago J G, Walia S, Sun J K, Cavallerano J D, Haddad Z A, Aiello L P, Silva P S
Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.
1] Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA [2] Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Eye (Lond). 2014 Mar;28(3):259-68. doi: 10.1038/eye.2014.1. Epub 2014 Feb 14.
To determine the influence of diabetes and diabetes type on ocular outcomes following central retinal vein occlusion (CRVO).
Retrospective chart review of all patients evaluated over a 4-year period in a tertiary diabetes eye care center. Ophthalmic findings were recorded including visual acuity and the presence of retinal neovascularization at presentation, after 3-6 months, and at last follow-up.
The records of 19,648 patients (13,571 diabetic; 6077 nondiabetic) were reviewed. The prevalence of CRVO in diabetic patients (N=72) and nondiabetic patients (N=27) were 0.5 and 0.4%, respectively. Disc neovascularization (21.3 vs 0.0%, P=0.05) and panretinal photocoagulation (PRP) (48.7 vs 21.4%, P=0.01) were more common in diabetic patients compared with nondiabetic patients. Compared with type 2 diabetic patients, retinal neovascularization (28.6 vs 3.7%, P=0.004) and subsequent PRP (78.6 vs 41.9%, P=0.01) were more likely in type 1 patients. Optic nerve head collateral vessels (CVs) were observed less than half as often (21.4 vs 56.5%, P=0.04) in patients with type 1 diabetes. Presence of optic nerve head CVs at baseline was associated with less likelihood of PRP (14.3 vs 46.1%, P=0.03).
In this cohort, the rates of CRVO in diabetic and nondiabetic patients were similar to previously published population-based studies. Following CRVO, diabetic patients had higher rates of disc neovascularization and were more likely to require subsequent PRP than nondiabetic patients. As compared with CRVO patients with type 2 diabetes, patients with type 1 diabetes and CRVO had worse anatomic outcomes with substantially increased risks of retinal neovascularization and PRP; however, final visual acuity outcomes were similar.
确定糖尿病及糖尿病类型对视网膜中央静脉阻塞（CRVO）后眼部预后的影响。
对一家三级糖尿病眼科护理中心4年内评估的所有患者进行回顾性病历审查。记录眼科检查结果，包括就诊时、3 - 6个月后及最后一次随访时的视力和视网膜新生血管情况。
回顾了19648例患者的记录（13571例糖尿病患者；6077例非糖尿病患者）。糖尿病患者（N = 72）和非糖尿病患者（N = 27）中CRVO的患病率分别为0.5%和0.4%。与非糖尿病患者相比，糖尿病患者的视盘新生血管形成（21.3%对0.0%，P = 0.05）和全视网膜光凝（PRP）（48.7%对21.4%，P = 0.01）更为常见。与2型糖尿病患者相比，1型糖尿病患者视网膜新生血管形成（28.6%对3.7%，P = 0.004）及随后进行PRP（78.6%对41.9%，P = 0.01）的可能性更高。1型糖尿病患者视神经乳头侧支血管（CVs）的观察频率不到一半（21.4%对56.5%，P = 0.04）。基线时存在视神经乳头CVs与进行PRP的可能性较小相关（1十四点三对46.1%，P = 0.03）。
在该队列中，糖尿病患者和非糖尿病患者的CRVO发生率与先前发表的基于人群的研究相似。CRVO后，糖尿病患者视盘新生血管形成率更高，且比非糖尿病患者更有可能需要后续PRP。与2型糖尿病CRVO患者相比，1型糖尿病CRVO患者的解剖学预后更差，视网膜新生血管形成和PRP的风险大幅增加；然而，最终视力预后相似。
