Dhasmana Renu, Sah Sonal, Gupta Neeti
Professor, Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University , Dehradun, Uttarakhand, India .
Retina Fellow, Department of Ophthalmology, Eye Q, Prakash Netra Kendra , NH2, Vipul Khand IV, Gomti Nagar, Lucknow, Uttar Pradesh, India .
J Clin Diagn Res. 2016 Jul;10(7):NC05-9. doi: 10.7860/JCDR/2016/19097.8107. Epub 2016 Jul 1.
Diabetic retina undergoes degenerative changes in retinal nerve fiber layer (RNFL) in addition to vascular changes. Loss of RNFL with changes in inner retina and their association with metabolic control have been studied with varied results in diabetic patients.
To compare the RNFL thickness between diabetic patients and age matched healthy controls and to correlate the thickness to metabolic control.
One hundred and sixty five patients were enrolled in the study out of which 50 served as controls, 58 patients were diabetic without retinopathy and 57 patients had diabetic retinopathy. Both eyes of all patients underwent optical coherence tomography scans for RNFL and ganglion cell complex. Foveal and parafoveal thickness were also measured. All the parameters were compared to patient's metabolic control.
RNFL thinning was observed in superotemporal (p-value = 0.001) and upper nasal sectors (p-value = 0.031) around the optic disc in eyes with diabetic retinopathy. Ganglion cell complex also showed statistically significant thinning in diabetic patients. Creatinine levels showed a weak negative correlation to the RNFL.
This study positively concluded that neurodegeneration in an early component of diabetic retinopathy.
糖尿病视网膜除了发生血管变化外,视网膜神经纤维层(RNFL)也会发生退行性改变。糖尿病患者视网膜神经纤维层的丧失以及视网膜内层的变化及其与代谢控制的关系已有研究,但结果各异。
比较糖尿病患者与年龄匹配的健康对照者的视网膜神经纤维层厚度,并将该厚度与代谢控制相关联。
165例患者纳入本研究,其中50例为对照,58例为无视网膜病变的糖尿病患者,57例为糖尿病视网膜病变患者。所有患者的双眼均接受了视网膜神经纤维层和神经节细胞复合体的光学相干断层扫描。还测量了黄斑中心凹和旁黄斑厚度。将所有参数与患者的代谢控制情况进行比较。
糖尿病视网膜病变患者的眼睛在视盘周围的颞上象限(p值 = 0.001)和鼻上象限(p值 = 0.031)观察到视网膜神经纤维层变薄。糖尿病患者的神经节细胞复合体也显示出统计学上的显著变薄。肌酐水平与视网膜神经纤维层呈弱负相关。
本研究肯定地得出结论,神经退行性变是糖尿病视网膜病变的早期组成部分。