Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2020 May;258(5):971-977. doi: 10.1007/s00417-020-04604-z. Epub 2020 Jan 30.
The aim of this study was to analyze choroidal structures in healthy subjects and patients with/without diabetic macular edema (DME).
This was a retrospective observation case control study. Four hundred and two eyes of patients with diabetes mellitus (DM), and 124 age-matched eyes of healthy subjects were enrolled in this study. DM patients were divided into 3 groups: presence of central-involved (CI) DME (n = 81) and nonCI-DME/non-DME (n = 321), based on OCT findings. Central choroidal thickness (CCT) and total choroidal, luminal, and stromal areas were determined using EDI-OCT and a binarization method, respectively. The luminal area expressed as a ratio of the total choroidal area was defined as the L/C ratio.
DM eyes showed a significantly lower L/C ratio than control eyes, whereas there was no significant difference in CCT or total choroidal, luminal, or stromal areas. There was no significant difference between CI-DME and non-DME groups in HbA1c, blood pressure, dyslipidemia, or renal function. CCT and total choroidal, luminal, and stromal areas were significantly greater in the CI-DME group than non-DME group (each P < 0.05).
These results suggest that CCT was thickened in the presence of DME, associated with both increased luminal and stromal areas, which might be related to the pathology of DME.
本研究旨在分析健康受试者和伴有/不伴有糖尿病性黄斑水肿(DME)的患者的脉络膜结构。
这是一项回顾性观察性病例对照研究。本研究纳入了 402 只糖尿病患者的眼和 124 只年龄匹配的健康受试者的眼。根据 OCT 结果,将糖尿病患者分为存在中心累及(CI)DME(n=81)和非 CI-DME/非 DME(n=321)三组。使用 EDI-OCT 和二值化方法分别确定中央脉络膜厚度(CCT)和总脉络膜、管腔和基质面积。将管腔面积表示为总脉络膜面积的比值,定义为 L/C 比值。
与对照组相比,糖尿病组的 L/C 比值显著降低,而 CCT 或总脉络膜、管腔和基质面积无显著差异。CI-DME 和非 DME 组之间的糖化血红蛋白、血压、血脂异常或肾功能无显著差异。与非 DME 组相比,CI-DME 组的 CCT 和总脉络膜、管腔和基质面积显著增加(均 P<0.05)。
这些结果表明,DME 存在时 CCT 增厚,与管腔和基质面积增加有关,这可能与 DME 的病理有关。