[不同阶段糖尿病视网膜病变与脉络膜厚度的相关性]

[Association of choroidal thickness with diabetic retinopathy at different stages].

作者信息

Wang Shaocheng, Lin Siyong, Zheng Yuezhong, Di Fusheng, Cao Xi, Liu Chang, Yang Jinkui

机构信息

Department of Endocrinology, Tianjin Third Central Hospital, Tianjin Medical University, Tianjin 300170, China.

Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijng Key Laboratory of Diabetes Research and Care, Beijing 100730, China, Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2015 Aug 25;95(32):2584-8.

PMID:26711604

Abstract

OBJECTIVE

To explore the association of choroidal thickness variations in type 2 diabetes mellitus (T2DM) patients with diabetic retinopathy (DR) at different stages.

METHODS

A total of 161 patients with T2DM were included in this study, from October 2012 to June 2014. According to Early Treatment Diabetic Retinopathy Study (ETDRS) criteria, the patients were divided into 5 groups: non-DR without diabetic macular edema (DME) group(DR-/DME- group, 45 eyes), nonproliferative diabetic retinopathy (NPDR) without DME group(NPDR+/DME- group, 58 eyes), proliferative diabetic retinopathy (PDR) without DME group (PDR+/DME- group, 12 eyes), NPDR with DME group (NPDR+/DME+ group, 41 eyes), PDR with DME group (PDR+/DME+ group, 5 eyes). Meanwhile, 60 normal subjects were enrolled as the control group. All study subjects received optical coherence tomography enhanced depth imaging (EDI-OCT) examination to detect and compare subfoveal choroidal thickness at different stages of DR.

RESULTS

Mean SFCT was (271 ± 36), (270 ± 35), (262 ± 38), (244 ± 36), (229 ± 35) µm respectively in control, DR-/DME-, NPDR+/DME-, PDR+/DME-, NPDR+/DME+ groups. The SFCTs of PDR+/DME- and NPDR+/DME+ group were statistically lower than that of control group (P=0.004, P=0.001). The SFCT of PDR+/DME- group was lower than that of DR-/DME- group (P=0.003), and there was also a significant difference of SFCT between NPDR+/DME+ and NPDR+/DME- group (P=0.001). There was linear correlation between SFCT and the logMAR best-corrected visual acuity (r=0.397, P<0.01), but the SFCT was independent of diabetic duration, fasting blood glucose, HbA1c, axial length, diastolic blood pressure (DBP) and systolic blood pressure SBP (r=-0.024, 0.159, 0.089, 0.036, 0.143, 0.057, all P>0.05). There was no significant difference of SFCT among different DME types (F=0.071, P>0.05).

CONCLUSION

The SFCT decreased with increasing severity of DR. To monitor the SFCT in T2DM patients may be helpful to evaluate the severity of DR and provide a new treatment conception.

摘要

目的

探讨2型糖尿病（T2DM）患者不同阶段糖尿病视网膜病变（DR）与脉络膜厚度变化的相关性。

方法

本研究纳入了2012年10月至2014年6月期间的161例T2DM患者。根据糖尿病视网膜病变早期治疗研究（ETDRS）标准，将患者分为5组：无糖尿病性黄斑水肿（DME）的非DR组（DR-/DME-组，45只眼）、无DME的非增殖性糖尿病视网膜病变（NPDR）组（NPDR+/DME-组，58只眼）、无DME的增殖性糖尿病视网膜病变（PDR）组（PDR+/DME-组，12只眼）、有DME的NPDR组（NPDR+/DME+组，41只眼）、有DME的PDR组（PDR+/DME+组，5只眼）。同时，纳入60名正常受试者作为对照组。所有研究对象均接受光学相干断层扫描增强深度成像（EDI-OCT）检查，以检测和比较DR不同阶段的黄斑下脉络膜厚度。

结果

对照组、DR-/DME-组、NPDR+/DME-组、PDR+/DME-组、NPDR+/DME+组的平均黄斑下脉络膜厚度（SFCT）分别为（271±36）、（270±35）、（262±38）、（244±36）、（229±35）μm。PDR+/DME-组和NPDR+/DME+组的SFCT低于对照组（P=0.004，P=0.001）。PDR+/DME-组的SFCT低于DR-/DME-组（P=0.003），NPDR+/DME+组和NPDR+/DME-组的SFCT也有显著差异（P=0.001）。SFCT与logMAR最佳矫正视力呈线性相关（r=0.397, P<0.01），但SFCT与糖尿病病程、空腹血糖、糖化血红蛋白、眼轴长度、舒张压（DBP）和收缩压（SBP）无关（r=-0.024、0.159、0.089、0.036、0.143、0.057，均P>0.05）。不同DME类型之间的SFCT无显著差异（F=0.071，P>0.05）。