Oliveira-Ferreira Cláudia, Leuzinger-Dias Mariana, Tavares-Ferreira João, Falcão-Reis F, Rocha-Sousa Amândio
Ophthalmology Department, Centro Hospitalar São João, Porto, Portugal.
Department of Surgery and Physiology, Faculty of Medicine of Porto University, Porto, Portugal.
J Ophthalmol. 2020 Feb 25;2020:3648941. doi: 10.1155/2020/3648941. eCollection 2020.
The role of retinal vasculature's dysfunction in the physiopathology of Diabetic Retinopathy (DR) has been extensively described. Recently, the existence of a diabetic choroidal vasculopathy has been proposed. The purpose of this study was to compare choroidal thickness (CT) in nondiabetic patients and in type 2 diabetic patients without retinopathy, using EDI SD-OCT. Additionally, considering the diabetic patient group, compare CT in patients with and without microalbuminuria. This retrospective study selected patients sent from primary health-care centers as part of the national screening of diabetic retinopathy. Inclusion criteria were diagnosis of type 2 diabetes mellitus, absence of diabetic retinopathy, and a 24 hours urinary albumin measurement in the last 3 months at the primary health-care center. Nondiabetic patients were selected from a database in the ophthalmology department, and only healthy patients were included. At the screening visit, all patients performed a complete ophthalmologic examination by the same examiner. All eyes were examined with SD- OCT, and all scans were performed in the EDI mode. Measurements were made at three points: subfoveal, 1500 m temporally and nasally to the foveal center. We included 110 eyes of 110 diabetic patients without diabetic retinopathy and 30 eyes of 30 healthy controls. Mean subfoveal CT was greater in diabetic patients without retinopathy (with normoalbuminuria or microalbuminuria) when compared with nondiabetic patients ( < 0.05). In diabetic patients without retinopathy, the subfoveal and temporal choroid was thicker among patients with microalbuminuria when compared with those of normoalbuminuric patients ( < 0.05). The subfoveal and temporal choroid was thicker among diabetic patients with microalbuminuria compared with nondiabetic patients. ( < 0.05). This study suggests that choroidal changes are present in type 2 diabetic patients even before the clinical development of retinopathy.
视网膜血管功能障碍在糖尿病视网膜病变（DR）病理生理过程中的作用已被广泛描述。最近，有人提出存在糖尿病性脉络膜血管病变。本研究的目的是使用增强深度成像谱域光学相干断层扫描（EDI SD-OCT）比较非糖尿病患者和无视网膜病变的2型糖尿病患者的脉络膜厚度（CT）。此外，在糖尿病患者组中，比较有和无微白蛋白尿患者的CT。这项回顾性研究选择了作为全国糖尿病视网膜病变筛查一部分从初级卫生保健中心送来的患者。纳入标准为2型糖尿病诊断、无糖尿病视网膜病变以及在初级卫生保健中心最近3个月内进行的24小时尿白蛋白测量。非糖尿病患者从眼科部门的数据库中选取，仅纳入健康患者。在筛查就诊时，所有患者由同一名检查者进行全面的眼科检查。所有眼睛均用谱域光学相干断层扫描（SD-OCT）检查，所有扫描均以增强深度成像（EDI）模式进行。测量在三个点进行：黄斑中心凹下、黄斑中心凹颞侧和鼻侧1500μm处。我们纳入了110例无糖尿病视网膜病变的糖尿病患者的110只眼和30例健康对照的30只眼。与非糖尿病患者相比，无视网膜病变（有正常白蛋白尿或微量白蛋白尿）的糖尿病患者黄斑中心凹下平均CT更大（<0.05）。在无视网膜病变的糖尿病患者中，与正常白蛋白尿患者相比，微量白蛋白尿患者的黄斑中心凹下和颞侧脉络膜更厚（<0.05）。与非糖尿病患者相比，微量白蛋白尿的糖尿病患者黄斑中心凹下和颞侧脉络膜更厚（<0.05）。这项研究表明，在2型糖尿病患者中，甚至在视网膜病变临床发展之前就存在脉络膜变化。
