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缺血性和非缺血性糖尿病黄斑病变中黄斑脉络膜厚度的特征分析

CHARACTERIZATION OF MACULAR CHOROIDAL THICKNESS IN ISCHEMIC AND NONISCHEMIC DIABETIC MACULOPATHY.

作者信息

Sheth Jay U, Giridhar Anantharaman, Rajesh Bindu, Gopalakrishnan Mahesh

机构信息

Department of Vitreo-Retina, Giridhar Eye Institute, Kochi, India.

出版信息

Retina. 2017 Mar;37(3):522-528. doi: 10.1097/IAE.0000000000001172.

Abstract

PURPOSE

To evaluate changes in macular choroidal thickness in eyes with ischemic and nonischemic diabetic maculopathy.

METHODS

Cross-sectional study of enhanced depth imaging optical coherence tomography of patients with diabetes. The diabetic eyes were divided into 3 groups: 1) eyes with no diabetic retinopathy (NDR); 2) those with diabetic retinopathy without macular ischemia (DR/MI-); and 3) those with diabetic retinopathy and macular ischemia (DR/MI+).

RESULTS

This analysis included 261 eyes of 160 patients. Eighty-eight eyes belonged to the NDR, 90 to the DR/MI-, and 83 to the DR/MI+ group. The choroidal thickness was significantly reduced in the DR/MI+ group as compared with the other 2 groups in the subfoveal region (NDR: 285.94 ± 80.38 μm, DR/MI-: 311.22 ± 94.55 μm, DR/MI+: 216.06 ± 58.41 μm; P < 0.001), nasally and temporally (P < 0.01). Between the NDR and DR/MI- groups, the choroidal thickness was significantly reduced nasally (P = 0.02) in the NDR group, but not subfoveally (P = 0.1) and temporally (P = 0.2). Notably, no statistically significant difference in central macular thickness was found between the DR/MI- (328.68 ± 103.28 μm) and DR/MI+ (341.99 ± 130.63 μm) groups (P = 1), although it was found to significantly increase in both these groups as compared with the NDR group (264.03 ± 27.74 μm; P < 0.001).

CONCLUSION

In diabetic maculopathy, an overall significant reduction was observed in macular choroidal thickness in eyes in ischemic stage as compared with nonischemic stage. In vivo evaluation of choroidal structural changes in the form of choroidal thickness may possibly be intuitive in understanding the pathogenesis of progression of diabetic maculopathy from nonischemic to ischemic stage, and associated functional damage.

摘要

目的

评估缺血性和非缺血性糖尿病黄斑病变患者黄斑脉络膜厚度的变化。

方法

对糖尿病患者进行增强深度成像光学相干断层扫描的横断面研究。糖尿病眼分为3组:1)无糖尿病视网膜病变(NDR)的眼;2)有糖尿病视网膜病变但无黄斑缺血(DR/MI-)的眼;3)有糖尿病视网膜病变且有黄斑缺血(DR/MI+)的眼。

结果

该分析纳入了160例患者的261只眼。88只眼属于NDR组,90只眼属于DR/MI-组,83只眼属于DR/MI+组。与其他两组相比,DR/MI+组在黄斑中心凹下区域的脉络膜厚度显著降低(NDR组:285.94±80.38μm,DR/MI-组:311.22±94.55μm,DR/MI+组:216.06±58.41μm;P<0.001),在鼻侧和颞侧也显著降低(P<0.01)。在NDR组和DR/MI-组之间,NDR组鼻侧的脉络膜厚度显著降低(P=0.02),但在黄斑中心凹下(P=0.1)和颞侧(P=0.2)未降低。值得注意的是,DR/MI-组(328.68±103.28μm)和DR/MI+组(341.99±130.63μm)之间的中心黄斑厚度未发现统计学上的显著差异(P=1),尽管与NDR组(264.03±27.74μm;P<0.001)相比,这两组的中心黄斑厚度均显著增加。

结论

在糖尿病黄斑病变中,与非缺血阶段相比,缺血阶段患者的黄斑脉络膜厚度总体上显著降低。以脉络膜厚度形式对脉络膜结构变化进行体内评估,可能有助于直观理解糖尿病黄斑病变从非缺血阶段进展到缺血阶段的发病机制以及相关的功能损害。

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