Gella Laxmi, Raman Rajiv, Kulothungan Vaitheeswaran, Saumya Pal Swakshyar, Ganesan Suganeswari, Sharma Tarun
Elite School of Optometry, No.8, G.S.T. Road, St. Thomas Mount, Chennai, Tamil Nadu, India Birla Institute of Technology and Science, Pilani, Rajasthan, India.
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Br J Ophthalmol. 2016 Jun;100(6):808-13. doi: 10.1136/bjophthalmol-2015-307064. Epub 2015 Sep 3.
To evaluate retinal sensitivity (RS) in subjects with diabetes in a population-based study and to elucidate associated risk factors for abnormal RS.
A subset of 357 subjects from Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study-II was included in this study. All subjects underwent detailed ophthalmic evaluation including microperimetry and spectral domain optical coherence tomography.
The prevalence of abnormal mean retinal sensitivity (MRS) was 89.1%. MRS was significantly reduced in subjects with diabetes but no retinopathy when compared with non-diabetic subjects. MRS was reduced in moderate non-proliferative diabetic retinopathy (DR) and macular oedema (ME) at 8° (p=0.04, p=0.01, respectively) and in ME at 10° (p=0.009) and 12° (p=0.036) compared with no DR. Significant negative correlation was found between MRS and best corrected visual acuity, duration of diabetes, glycosylated haemoglobin and central foveal thickness. Increased retinal thickness remained a significant risk factor (OR, 1.02; p=0.044) for abnormal MRS. Altered inner retinal layers and foveal contour were associated with reduced MRS among subjects with DR and presence of epiretinal membrane, altered foveal contour and altered retinal pigment epithelium were associated with reduced MRS.
Reduced RS in those subjects with diabetes but no retinopathy suggests the early neuronal damage in type 2 diabetes mellitus.
在一项基于人群的研究中评估糖尿病患者的视网膜敏感度（RS），并阐明RS异常的相关危险因素。
本研究纳入了来自桑卡拉奈特拉亚糖尿病视网膜病变流行病学和分子遗传学研究-II的357名受试者。所有受试者均接受了详细的眼科评估，包括微视野计检查和光谱域光学相干断层扫描。
平均视网膜敏感度（MRS）异常的患病率为89.1%。与非糖尿病受试者相比，糖尿病但无视网膜病变的受试者MRS显著降低。与无糖尿病视网膜病变（DR）相比，中度非增殖性糖尿病视网膜病变（DR）和黄斑水肿（ME）在8°时MRS降低（分别为p = 0.04，p = 0.01），ME在10°（p = 0.009）和12°（p = 0.036）时MRS降低。发现MRS与最佳矫正视力、糖尿病病程、糖化血红蛋白和中心凹厚度之间存在显著负相关。视网膜厚度增加仍然是MRS异常的一个重要危险因素（OR，1.02；p = 0.044）。在患有DR的受试者中，视网膜内层改变和中心凹轮廓改变与MRS降低有关，视网膜前膜的存在、中心凹轮廓改变和视网膜色素上皮改变与MRS降低有关。
糖尿病但无视网膜病变的患者RS降低提示2型糖尿病早期存在神经元损伤。
