Ruiz-Ocaña P, Espinoza Requena P, Alonso-Ojembarrena A, Alemany Márquez P, Jiménez Carmona S, Lechuga-Sancho A M
Diabetes and Metabolism Unit, Department of Pediatrics, University Hospital Puerta del Mar, Cádiz, Spain.
Department of Ophthalmology, University Hospital Puerta del Mar, Cádiz, Spain.
Int J Endocrinol. 2018 Apr 26;2018:1078531. doi: 10.1155/2018/1078531. eCollection 2018.
The retina functions as a neurovascular unit. How early vascular alterations affect neuronal layers remains controversial; early vascular failure could lead to edema increasing retinal thicknesses, but alternatively neuronal loss could lead to reduced retinal thickness. . To evaluate retinal thickness in a cohort of pediatric patients with type 1 diabetes mellitus (PwT1DM) and to analyze differences according to the presence or absence of nonproliferative diabetic retinopathy (NPDR), poor metabolic control, and diabetes duration. . We performed retinographies and optical coherence tomography (OCT) (TOPCON 3D1000®) to PwT1DM followed at our center and healthy controls. Measurements of the control group served to calculate reference values. . 59 PwT1DM (age 12.51 ± 2.59) and 22 healthy controls (age 10.66 ± 2.51) volunteered. Only two PwT1DM, both adolescents with poor metabolic control, presented NPRD. Both showed decreased thicknesses and retinal volumes. The odds ratio of having decreased retinal thickness when signs of NPDR were present was 11.72 (95% IC 1.16-118.28; = 0.036). . PwT1DM with NPDR have increased odds of decreased retinal thicknesses and volumes. Whether these changes are reversible by improving metabolic control or not remains to be elucidated.
视网膜作为一个神经血管单元发挥作用。早期血管改变如何影响神经元层仍存在争议；早期血管功能衰竭可能导致水肿，增加视网膜厚度，但反之，神经元丢失可能导致视网膜厚度减小。为了评估1型糖尿病儿童患者（PwT1DM）队列中的视网膜厚度，并根据是否存在非增殖性糖尿病视网膜病变（NPDR）、代谢控制不佳和糖尿病病程分析差异。我们对在我们中心随访的PwT1DM患者和健康对照者进行了视网膜照相和光学相干断层扫描（OCT）（TOPCON 3D1000®）。对照组的测量用于计算参考值。59名PwT1DM患者（年龄12.51±2.59岁）和22名健康对照者（年龄10.66±2.51岁）自愿参与。只有两名PwT1DM患者，均为代谢控制不佳的青少年，出现了NPDR。两人均显示视网膜厚度和体积减小。出现NPDR体征时视网膜厚度降低的优势比为11.72（95%置信区间1.16 - 118.28；P = 0.036）。患有NPDR的PwT1DM患者视网膜厚度和体积降低的几率增加。这些变化是否可通过改善代谢控制而逆转仍有待阐明。
