神经节细胞层变薄与糖尿病黄斑水肿消退后视力不良的相关性。

Correlation between ganglion cell layer thinning and poor visual function after resolution of diabetic macular edema.

机构信息

Service d'Ophtalmologie, Hôpital Lariboisière, AP-HP, Université Paris 7-Sorbonne Paris Cité, Paris, France.

出版信息

Invest Ophthalmol Vis Sci. 2015 Jan 8;56(2):978-82. doi: 10.1167/iovs.14-15503.

Abstract

PURPOSE

To assess the thickness of the ganglion cell-inner plexiform layer (GCIPL) in eyes with resolved diabetic macular edema (DME), using spectral-domain optical coherence tomography (SD-OCT), and its relationship with the visual function.

METHODS

This retrospective observational case-control cohort study included eyes of diabetic patients with resolved DME (r-DME eyes), that is, normal central macular thickness (CMT) after treatment of DME, and eyes of aged-matched diabetic patients without maculopathy (no-DME eyes). The GCIPL thickness was measured on a macular cube SD-OCT scan using a specific automatic segmentation algorithm. Linear regression analyses were performed to determine the association between the GCIPL thickness and the visual acuity (VA) measured at the time of the OCT measurement.

RESULTS

Average GCIPL thickness was reduced in r-DME eyes compared with no-DME eyes (74 ± 14 μm versus 83.2 ± 6 μm, P = 0.0189), whereas no significant difference in mean CMT was observed (260.0 ± 34 μm versus 265.7 ± 22 μm, P = 0.847). Visual acuity significantly correlated with the average GCIPL thickness (r = 0.8, P < 0.0001) and minimum GCIPL thickness (r = 0.84, P < 0.0001) in r-DME eyes.

CONCLUSIONS

Despite favorable anatomic response and restoration of a CMT in the range of normal values after resolution of DME, the GCIPL thickness in r-DME eyes was lower than that in no-DME eyes and correlated with the VA. These results suggest that inner retinal alterations occurring in patients with DME and diabetic retinopathy may lead to visual deficiency persisting after treatment.

摘要

目的

利用频域光相干断层扫描(SD-OCT)评估糖尿病性黄斑水肿(DME)消退后眼的神经节细胞-内丛状层(GCIPL)厚度,并探讨其与视力的关系。

方法

本回顾性观察性病例对照队列研究纳入了 DME 消退(r-DME 眼)的糖尿病患者眼和年龄匹配的无黄斑病变(无 DME 眼)的糖尿病患者眼。使用特定的自动分割算法在黄斑立方 SD-OCT 扫描上测量 GCIPL 厚度。进行线性回归分析,以确定 GCIPL 厚度与 OCT 测量时的视力(VA)之间的关系。

结果

与无 DME 眼相比,r-DME 眼的平均 GCIPL 厚度较低(74 ± 14 µm 比 83.2 ± 6 µm,P = 0.0189),而平均 CMT 无显著差异(260.0 ± 34 µm 比 265.7 ± 22 µm,P = 0.847)。r-DME 眼中,VA 与平均 GCIPL 厚度(r = 0.8,P < 0.0001)和最小 GCIPL 厚度(r = 0.84,P < 0.0001)显著相关。

结论

尽管 DME 消退后,解剖结构恢复良好,CMT 值恢复至正常范围,但 r-DME 眼的 GCIPL 厚度仍低于无 DME 眼,且与 VA 相关。这些结果表明,DME 和糖尿病性视网膜病变患者发生的内层视网膜改变可能导致治疗后持续存在视力缺陷。

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