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早期糖尿病视网膜病变的结构-功能关系:光学相干断层扫描(OCT)与微视野计的空间相关性分析

Structure-function relationship in early diabetic retinopathy: a spatial correlation analysis with OCT and microperimetry.

作者信息

Montesano G, Gervasoni A, Ferri P, Allegrini D, Migliavacca L, De Cillà S, Rossetti L

机构信息

University of Milan, San Paolo Hospital, Milan, Italy.

A. Manzoni Hospital, Lecco, Italy.

出版信息

Eye (Lond). 2017 Jun;31(6):931-939. doi: 10.1038/eye.2017.27. Epub 2017 Mar 3.

Abstract

PurposeTo study the correlation of the local ganglion cell layer-inner plexiform layer (GCL-IPL) thickness with corresponding retinal sensitivity as studied with microperimetry in patients with Type 2 diabetes and no signs of diabetic retinopathy.Patients and methodsWe analyzed 35 healthy subjects (68 eyes) and 26 Type 2 diabetic patients (48 eyes) with no signs of diabetic retinopathy. We tested best corrected visual acuity (BCVA), monocular and binocular constrast sensitivity (CS, Pelli - Robson chart) and retinal sensitivity with microperimetry, and acquired dense macular SD-OCT scans. We then studied the correlation between local GCL-IPL thickness and local sensitivity.ResultsMean BCVA was 1.09 (±1.03) decimals in diabetic subjects and 1.02 (±0.15) decimals in healthy subjects. Only binocular CS was significantly higher in healthy subjects (1.18±0.42 for healthy subjects, 1.62±0.63 for diabetic subjects). In both local and global analysis we observed higher GCL-IPL thickness and higher sensitivity in normal compared with diabetic subjects, but no difference reached significance (p<0.05). Using a mixed multivariate linear model, we found a significant correlation between retinal sensitivity and the correspondent GCL-IPL thickness in diabetic subjects (0.022±0.006 dB/μm, p=0.0007) but not in healthy subjects (-0.002±0.006 dB/μm, p=0.77).Conclusiondespite close similarities between the two groups, we found a significant difference in the structure-function relationship in diabetic subjects without diabetic retinopathy, suggesting that diabetes might act as an additional effect in the normal deterioration of the visual function related to the inner retina.

摘要

目的

研究2型糖尿病且无糖尿病视网膜病变迹象患者的局部神经节细胞层-内丛状层(GCL-IPL)厚度与微视野检查所测相应视网膜敏感度之间的相关性。

患者与方法

我们分析了35名无糖尿病视网膜病变迹象的健康受试者(68只眼)和26名2型糖尿病患者(48只眼)。我们检测了最佳矫正视力(BCVA)、单眼和双眼对比敏感度(CS,佩利-罗布森图表)以及微视野检查的视网膜敏感度,并获取了密集的黄斑区SD-OCT扫描图像。然后我们研究了局部GCL-IPL厚度与局部敏感度之间的相关性。

结果

糖尿病受试者的平均BCVA为1.09(±1.03)小数,健康受试者为1.02(±0.15)小数。仅健康受试者的双眼CS显著更高(健康受试者为1.18±0.42,糖尿病受试者为1.62±0.63)。在局部和整体分析中,我们均观察到与糖尿病受试者相比,正常受试者的GCL-IPL厚度更高且敏感度更高,但差异均未达到显著水平(p<0.05)。使用混合多变量线性模型,我们发现糖尿病受试者的视网膜敏感度与相应的GCL-IPL厚度之间存在显著相关性(0.022±0.006 dB/μm,p=0.0007),而健康受试者中未发现这种相关性(-0.002±0.006 dB/μm,p=0.77)。

结论

尽管两组之间有诸多相似之处,但我们发现无糖尿病视网膜病变的糖尿病受试者在结构-功能关系上存在显著差异,这表明糖尿病可能在与视网膜内层相关的视觉功能正常衰退过程中起到额外作用。

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