视盘视网膜神经纤维层厚度对糖尿病周围神经病变的诊断价值

Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy.

作者信息

Wu Xiao-Hong, Fang Jing-Wen, Huang Yin-Qiong, Bai Xue-Feng, Zhuang Yong, Chen Xiao-Yu, Lin Xia-Hong

机构信息

Department of Endocrinology, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China.

Department of Endocrinology, the First Hospital of Quanzhou, Quanzhou 362000, China.

出版信息

J Zhejiang Univ Sci B. 2020;21(11):911-920. doi: 10.1631/jzus.B2000225.

DOI:10.1631/jzus.B2000225

PMID:33150774

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7691684/

Abstract

OBJECTIVE

To investigate the value of optic disc retinal nerve fiber layer (RNFL) thickness in the diagnosis of diabetic peripheral neuropathy (DPN).

METHODS

Ninety patients with type 2 diabetes, including 60 patients without DPN (NDPN group) and 30 patients with DPN (DPN group), and 30 healthy participants (normal group) were enrolled. Optical coherence tomography (OCT) was used to measure the four quadrants and the overall average RNFL thickness of the optic disc. The receiver operator characteristic curve was drawn and the area under the curve (AUC) was calculated to evaluate the diagnostic value of RNFL thickness in the optic disc area for DPN.

RESULTS

The RNFL thickness of the DPN group was thinner than those of the normal and NDPN groups in the overall average ((101.07± 12.40) µm vs. (111.07±6.99) µm and (109.25±6.90) µm), superior quadrant ((123.00±19.04) µm vs. (138.93±14.16) µm and (134.47±14.34) µm), and inferior quadrant ((129.37±17.50) µm vs. (143.60±12.22) µm and (144.48±14.10) µm), and the differences were statistically significant. The diagnostic efficiencies of the overall average, superior quadrant, and inferior quadrant RNFL thicknesses, and a combined index of superior and inferior quadrant RNFL thicknesses were similar, and the AUCs were 0.739 (95% confidence interval (CI) 0.635-0.826), 0.683 (95% CI 0.576-0.778), 0.755 (95% CI 0.652-0.840), and 0.773 (95% CI 0.672-0.854), respectively. The diagnostic sensitivity of RNFL thickness in the superior quadrant reached 93.33%.

CONCLUSIONS

The thickness of the RNFL in the optic disc can be used as a diagnostic method for DPN.

摘要

目的

探讨视盘视网膜神经纤维层（RNFL）厚度在糖尿病周围神经病变（DPN）诊断中的价值。

方法

纳入90例2型糖尿病患者，其中60例无DPN患者（非DPN组）和30例DPN患者（DPN组），以及30名健康参与者（正常组）。采用光学相干断层扫描（OCT）测量视盘四个象限及整体平均RNFL厚度。绘制受试者工作特征曲线并计算曲线下面积（AUC），以评估视盘区域RNFL厚度对DPN的诊断价值。

结果

DPN组的整体平均RNFL厚度（（101.07±12.40）μm vs.（111.07±6.99）μm和（109.25±6.90）μm）、上象限（（123.00±19.04）μm vs.（138.93±14.16）μm和（134.47±14.34）μm）及下象限（（129.37±17.50）μm vs.（143.60±12.22）μm和（144.48±14.10）μm）均较正常组和非DPN组薄，差异具有统计学意义。整体平均、上象限、下象限RNFL厚度及上下象限RNFL厚度联合指标的诊断效率相似，AUC分别为0.739（95%置信区间（CI）0.635 - 0.826）、0.683（95%CI 0.576 - 0.778）、0.755（95%CI 0.652 - 0.840）和0.773（95%CI 0.672 - 0.854）。上象限RNFL厚度的诊断敏感性达93.33%。