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糖尿病性黄斑水肿脉络膜血管结构的改变。

Alteration of choroidal vascular structure in diabetic macular edema.

机构信息

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.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2020 May;258(5):971-977. doi: 10.1007/s00417-020-04604-z. Epub 2020 Jan 30.

Abstract

PURPOSE

The aim of this study was to analyze choroidal structures in healthy subjects and patients with/without diabetic macular edema (DME).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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