Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, National Clinical Research Center for Eye Diseases, Shanghai Key laboratory of Ocular Fundus Diseases, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Acta Ophthalmol. 2022 Feb;100(1):e157-e166. doi: 10.1111/aos.14885. Epub 2021 May 5.
To investigate the changes in optic disc morphology and peripapillary atrophy (PPA) in diabetic children and adults without diabetic retinopathy (DR) or visual impairment (VI).
This cross-sectional study included two groups of subjects. One group included 91 children with type 1 diabetes mellitus (T1DM) and 86 healthy children, and the other group included 444 adults with T2DM and 442 healthy controls. The optic disc parameters including major and minor axis lengths, optic disc ovality (ODO), optic disc tilt, optic disc area and β-PPA area were analysed in all subjects. Optic disc rotation and the Bergmeister papilla were analysed only in children. Patients with diabetes and healthy controls were compared in each group of the study population.
In both groups, patients with diabetes and healthy controls were matched for age, sex and axial length (AL). Among the children, β-PPA area was significantly smaller in those with diabetes (0.29 ± 0.43 mm ) than in the healthy controls (0.46 ± 0.58 mm , p < 0.05). Multiple linear regression analysis showed that diagnosis of DM was negatively associated with β-PPA area. Longer AL and higher body mass index (BMI) were positively associated with β-PPA area. Among adults, ODO was significantly larger in those with diabetes (1.14 ± 0.09) than in healthy controls (1.12 ± 0.06, p < 0.05). Multiple linear regression analysis showed that the BMI and DM were potential risk factors affecting ODO.
Hyperglycaemia had different effects on the optic disc in children and adults. Unlike in healthy controls, hyperglycaemia had an impact on the peripapillary tissue in children and on optic disc shape in adults before DR and VI development.
研究无糖尿病视网膜病变（DR）或视力损害（VI）的糖尿病儿童和成人的视盘形态和视盘周围萎缩（PPA）变化。
本横断面研究包括两组受试者。一组包括 91 例 1 型糖尿病（T1DM）患儿和 86 例健康儿童，另一组包括 444 例 2 型糖尿病（T2DM）成人和 442 例健康对照者。所有受试者均分析视盘参数，包括长径和短径、视盘椭圆度（ODO）、视盘倾斜、视盘面积和β-PPA 面积。仅在儿童中分析视盘旋转和伯格乳头。比较研究人群中各组的糖尿病患者和健康对照组。
两组中，糖尿病患者和健康对照组的年龄、性别和眼轴长度（AL）相匹配。在儿童中，糖尿病患儿（0.29±0.43mm）的β-PPA 面积明显小于健康对照组（0.46±0.58mm，p<0.05）。多元线性回归分析显示，DM 诊断与β-PPA 面积呈负相关。更长的 AL 和更高的体重指数（BMI）与β-PPA 面积呈正相关。在成人中，糖尿病患者的 ODO 明显大于健康对照组（1.14±0.09 vs. 1.12±0.06，p<0.05）。多元线性回归分析显示，BMI 和 DM 是影响 ODO 的潜在危险因素。
高血糖对儿童和成人的视盘有不同的影响。与健康对照组不同，在 DR 和 VI 发生之前，高血糖对视盘周围组织产生影响，而对成人视盘形状产生影响。
