Arıkan Sedat, Erşan İsmail, Eroğlu Mustafa, Yılmaz Mehmet, Tufan Hasan Ali, Gencer Baran, Kara Selçuk, Aşık Mehmet
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Ophthalmology, Çanakkale, Turkey.
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Endocrinology and Metabolism, Çanakkale, Turkey.
Turk J Ophthalmol. 2016 Dec;46(6):264-269. doi: 10.4274/tjo.68888. Epub 2016 Dec 1.
To investigate whether retinal neurodegeneration and impairment in contrast sensitivity (CS), which have been demonstrated to begin in diabetic patients before the presence of signs of diabetic retinal vasculopathy, also occur in the stage of insulin resistance.
The average, minimum and sectoral (inferior, superior, inferonasal, superonasal, inferotemporal and superotemporal) thicknesses of the ganglion cell-inner plexiform layer (GCIPL) measured using optical coherence tomography were compared between an insulin-resistant group and control group in order to evaluate the presence of retinal neurodegeneration. The CS of the two groups was also compared according to the logarithmic values measured at spatial frequencies of 1.5, 3, 6, 12 and 18 cycles per degree in photopic light using functional acuity contrast test (FACT).
Twenty-five eyes of 25 patients with insulin resistance (insulin resistant group) and 25 eyes of 25 healthy subjects (control group) were included in this study. There were no statistically significant differences between the two groups in any of the spatial frequencies in the FACT. The mean average GCIPL thickness and mean GCIPL thickness in the inferotemporal sector were significantly less in the insulin-resistant group when compared with the control group (mean average GCIPL thicknesses in the insulin-resistant and control groups were 83.6±4.7 µm and 86.7±3.7 µm respectively, p=0.01; mean inferotemporal GCIPL thicknesses in the insulin-resistant and control groups were 83±6.0 µm and 86.7±4.6 µm respectively, p=0.02).
Although it may not lead to functional visual impairment such as CS loss, the retinal neurodegeneration seen in diabetic patients may begin in the insulin resistance stage.
研究视网膜神经变性及对比敏感度（CS）受损情况（这两种情况已证实在糖尿病患者出现糖尿病视网膜血管病变体征之前就已开始）是否也发生在胰岛素抵抗阶段。
使用光学相干断层扫描测量神经节细胞 - 内网状层（GCIPL）的平均、最小及扇形（下方、上方、鼻下、鼻上、颞下和颞上）厚度，比较胰岛素抵抗组和对照组，以评估视网膜神经变性情况。还使用功能性视力对比测试（FACT），根据在明视光下每度1.5、3、6、12和18周空间频率下测得的对数值，比较两组的CS。
本研究纳入了25例胰岛素抵抗患者的25只眼（胰岛素抵抗组）和25名健康受试者的25只眼（对照组）。FACT中任何空间频率下两组之间均无统计学显著差异。与对照组相比，胰岛素抵抗组的平均GCIPL厚度及颞下扇形的GCIPL平均厚度显著更低（胰岛素抵抗组和对照组的GCIPL平均厚度分别为83.6±4.7 µm和86.7±3.7 µm，p = 0.01；胰岛素抵抗组和对照组的颞下GCIPL平均厚度分别为83±6.0 µm和86.7±4.6 µm，p = 0.02）。
虽然糖尿病患者中所见的视网膜神经变性可能不会导致如CS丧失等功能性视力损害，但可能始于胰岛素抵抗阶段。
