Kocak Altintas Ayse Gul, Gulpamuk Bayram, Cankurtaran Veysel, Ilhan Cagri, Citirik Mehmet
Associate Professor, University of Health Sciences, Ankara Ulucanlar Eye Education and Research Hospital, Ankara, Turkey.
Konya BeyhekimState Hospital, Konya, Turkey.
Med Hypothesis Discov Innov Ophthalmol. 2018 Spring;7(1):10-16.
This study aimed at evaluating the correlation between changes in Hemoglobin A1c (HbA1c) and fasting serum lipids, and Central Macular Thickness (CMT) in patients with Non-Proliferative Diabetic Retinopathy (NPDR). In the current research, both eyes of 68 patients with mild or moderate NPDR, without clinically significant macular edema, were studied. Levels of fasting serum lipids, HbAlc, and CMT were measured during the first visit and at the end of the follow-up period (3 months). For statistical analysis, CMTs of each eye were studied and the correlation of changes was investigated. Additionally, the direction of changes in CMT for each eye was determined, and whether the changes in both eyes were symmetrical was investigated. Out of 68 patients, 24 were male and 44 were female. The mean CMT of all eyes was 290.05 ± 48.90 µm during the first visit and 286.80 ± 37.57 µm on the 3rd month follow-up. The mean HbAlc was 8.71 ± 1.82% at first visit to the hospital and the mean HbAlc was 8.39 ± 1.65% at the final visit. Although the changes in HbA1c and CMT during the follow-up period were statistically insignificant, the correlation of these 2 values was statistically significant (p=0.01). However, amongst l3 patients, the CMTs were asymmetrically changed in each eye during the follow-up period. To the best of the author's knowledge, this was the first study, which indicated a significant correlation in changes of CMT and HbA1c, even amongst patients with low-grade diabetic retinopathy. Demonstration of asymmetric changes in CMT of each treatment-naive eye of the same patient, during changes in systemic conditions, was another important finding of this study.
本研究旨在评估非增殖性糖尿病视网膜病变(NPDR)患者糖化血红蛋白(HbA1c)变化与空腹血脂及黄斑中心厚度(CMT)之间的相关性。在当前研究中,对68例轻度或中度NPDR且无临床显著性黄斑水肿的患者的双眼进行了研究。在首次就诊时和随访期结束时(3个月)测量空腹血脂、HbAlc和CMT水平。为进行统计分析,对每只眼睛的CMT进行研究并调查变化的相关性。此外,确定每只眼睛CMT变化的方向,并调查双眼变化是否对称。68例患者中,男性24例,女性44例。首次就诊时所有眼睛的平均CMT为290.05±48.90 µm,随访第3个月时为286.80±37.57 µm。首次就诊时平均HbAlc为8.71±1.82%,末次就诊时平均HbAlc为8.39±1.65%。尽管随访期间HbA1c和CMT的变化在统计学上无显著意义,但这两个值的相关性具有统计学意义(p=0.01)。然而,在13例患者中,随访期间每只眼睛的CMT变化不对称。据作者所知,这是第一项表明即使在低度糖尿病视网膜病变患者中,CMT变化与HbA1c之间也存在显著相关性的研究。同一患者未经治疗的每只眼睛在全身状况变化期间CMT出现不对称变化,这是本研究的另一项重要发现。