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糖尿病患者未经治疗眼的脉络膜厚度变化:扫频源光学相干断层扫描研究。

Choroidal thickness changes in non-treated eyes of patients with diabetes: swept-source optical coherence tomography study.

机构信息

Department of Ophthalmology, Semmelweis University, Mária 39, Budapest, 1085, Hungary.

2nd Department of Internal Medicine, Semmelweis University, Szentkirályi 46, Budapest, 1088, Hungary.

出版信息

Acta Diabetol. 2018 Sep;55(9):927-934. doi: 10.1007/s00592-018-1169-0. Epub 2018 Jun 6.

Abstract

AIMS

To measure choroidal thickness (CT) in diabetic eyes and its correlation with metabolic status and the severity of diabetic retinopathy (DR).

MATERIALS AND METHODS

Prospective cross-sectional study using swept-source optical coherence tomography. CT maps of 96 treatment naïve eyes of 48 patients with diabetes were compared to 46 eyes of 23 healthy controls. CT changes and their relation to diabetes, age, gender, disease duration, hypertension (HT), hemoglobin A1c level, type and severity of DR were evaluated.

RESULTS

A significantly thinner choroid was measured in patients with diabetes compared to controls (p < 0.009). In the diabetic group age, gender, disease duration and HT were significantly correlated with CT in univariable regression models (p < 0.05). In multivariable analysis, the duration of diabetes significantly negatively correlated with CT (p = 0.02). According to analysis of variance, there was a significant difference among means of CT in different stages of DR (p = 0.002), with thinner CT in cases with more advanced DR. In a multivariable predictive model, thinner CT was associated with an increased risk for the presence of DR (p = 0.02).

CONCLUSIONS

Diabetes mellitus itself and the severity of DR affect CT significantly, even after adjusting for the effects of confounding systemic factors. Disease duration seems to be associated with a reduction of choroidal thickness. Decreased CT proved to be correlated with the severity of DR.

摘要

目的

测量糖尿病患者的脉络膜厚度(CT)及其与代谢状态和糖尿病视网膜病变(DR)严重程度的相关性。

材料和方法

使用扫频源光学相干断层扫描进行前瞻性横断面研究。将 48 例糖尿病患者的 96 只未经治疗的眼的 CT 图谱与 23 名健康对照者的 46 只眼进行比较。评估 CT 变化及其与糖尿病、年龄、性别、病程、高血压(HT)、糖化血红蛋白水平、DR 类型和严重程度的关系。

结果

与对照组相比,糖尿病患者的脉络膜明显变薄(p<0.009)。在糖尿病组中,年龄、性别、病程和 HT 在单变量回归模型中与 CT 显著相关(p<0.05)。在多变量分析中,糖尿病病程与 CT 呈显著负相关(p=0.02)。根据方差分析,DR 不同阶段的 CT 均值存在显著差异(p=0.002),DR 较严重的病例 CT 较薄。在多变量预测模型中,CT 变薄与 DR 存在的风险增加相关(p=0.02)。

结论

即使在调整了混杂的系统性因素的影响后,糖尿病本身和 DR 的严重程度也会显著影响 CT。病程似乎与脉络膜厚度的减少有关。CT 降低与 DR 的严重程度相关。

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