Ucgul Atilgan Cemile, Atilgan Kadir Gokhan, Kosekahya Pinar, Caglayan Mehtap, Sendul Selam Yekta, Yilmazbas Pelin
Ankara Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.
Department of Nephrology, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Eur J Ophthalmol. 2020 Jan;30(1):19-25. doi: 10.1177/1120672118811256. Epub 2018 Nov 8.
To investigate the effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus with no or mild diabetic retinopathy and to investigate the relationship between macular thickness and metabolic parameters.
Fifty eight eyes of 58 patients without diabetic retinopathy (group 1) in microalbuminuria stage, 42 eyes of 42 patients with mild diabetic retinopathy (group 2) in microalbuminuria stage, and 50 eyes of 50 patients without diabetic retinopathy and microalbuminuria (group 3) were included in this study. After detailed ophthalmologic examination, all patients underwent spectral domain-optical coherence tomography measurements. Macular thickness was noted from nine different areas (fovea, four parafoveal, and four perifoveal areas) and compared between groups. The correlations between macular thickness and age, duration of diabetes mellitus, microalbuminuria, serum urea, creatinine, glycosylated hemoglobin (HbAIc), albumin, sodium (Na), and urinary Na were evaluated.
The mean age was 53.29 ± 6.49 in group 1, 55.86 ± 6.97 in group 2, and 52.98 ± 5.66 years in group 3 (p = 0.06). The macular thickness values of superior, inferior, and nasal parafoveal areas were significantly different between groups (p = 0.001, p = 0.006, and p = 0.03, respectively). Bonferroni post test revealed that this difference originated from the difference between group 2 and 3 (p < 0.05 for all values). There were significant negative correlations between the macular thickness values of parafoveal areas and serum urea, HbA1c, albumin, microalbuminuria levels (p < 0.05 for all values).
In this study, a significantly decreased parafoveal macular thickness was measured in patients with mild diabetic retinopathy and microalbuminuria compared to patients without diabetic retinopathy and microalbuminuria.
研究微量白蛋白尿对无糖尿病视网膜病变或轻度糖尿病视网膜病变的2型糖尿病患者黄斑厚度的影响，并探讨黄斑厚度与代谢参数之间的关系。
本研究纳入了58例处于微量白蛋白尿阶段且无糖尿病视网膜病变患者的58只眼（第1组）、42例处于微量白蛋白尿阶段且患有轻度糖尿病视网膜病变患者的42只眼（第2组）以及50例无糖尿病视网膜病变和微量白蛋白尿患者的50只眼（第3组）。在进行详细的眼科检查后，所有患者均接受了频域光学相干断层扫描测量。记录黄斑九个不同区域（中央凹、四个中央凹旁区域和四个中央凹周区域）的厚度，并在组间进行比较。评估黄斑厚度与年龄、糖尿病病程、微量白蛋白尿、血清尿素、肌酐、糖化血红蛋白（HbAIc）、白蛋白、钠（Na）和尿钠之间的相关性。
第1组的平均年龄为53.29±6.49岁，第2组为55.86±6.97岁，第3组为52.98±5.66岁（p = 0.06）。组间中央凹上、下和鼻侧旁区域的黄斑厚度值存在显著差异（分别为p = 0.001、p = 0.006和p = 0.03）。Bonferroni事后检验显示，这种差异源于第2组和第3组之间的差异（所有值的p < 0.05）。中央凹旁区域的黄斑厚度值与血清尿素、HbA1c、白蛋白、微量白蛋白尿水平之间存在显著负相关（所有值的p < 0.05）。
在本研究中，与无糖尿病视网膜病变和微量白蛋白尿的患者相比，患有轻度糖尿病视网膜病变和微量白蛋白尿的患者中央凹旁黄斑厚度显著降低。
