中国糖尿病视网膜病变患者中的潜伏性糖尿病性黄斑水肿

Latent Diabetic Macular Edema in Chinese Diabetic Retinopathy Patients.

作者信息

Bai Xue, Hua Rui

机构信息

Department of Ophthalmology, First Hospital of China Medical University, Shenyang, China.

出版信息

Front Med (Lausanne). 2021 Oct 4;8:739656. doi: 10.3389/fmed.2021.739656. eCollection 2021.

DOI:10.3389/fmed.2021.739656

PMID:34671623

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8520952/

Abstract

To compare the detection rates of optical coherence tomography (OCT) and fluorescein angiography (FA) in a diabetic macular edema (DME) and the severity of diabetic retinopathy in both color fundus images (CFI) and FA, and to investigate the predictive factors in macular leakages in FA. This was a retrospective study, and a total of 132 eyes of 77 patients with diabetic retinopathy were enrolled. Macular OCT, FA, and CFI were reviewed and measured. Central foveal thickness was also measured. The severity of diabetic retinopathy in FA was significantly higher than that in CFI ( < 0.001). OCT detected 26 eyes with DMEs, which included the following: 13 eyes with cystoid macular edemas; 13 eyes with serous retinal detachments; 11 eyes with diffuse retinal thickening; 4 eyes with vitreomacular interface abnormalities. In contrast, 72 out of 132 eyes (54.5%) showed macular leakages in FA, which was significantly higher than that detected by OCT ( < 0.001). Compared with FA, the sensitivity and the specificity of OCT in detecting DMEs were 30.6 and 93.3%, respectively. However, central foveal thickness was not significantly different between the patients with non-clinically significant macular edema (CSME, 253.1 ± 26.95 μm) and slight CSME (270.9 ± 37.11 μm, = 0.204). The mean central foveal thickness in diabetic macular edema (FA) eyes was 271.8 ± 66.02 μm, which was significantly higher than that (253. ± 25.21 μm) in non-DME (FA) eyes ( = 0.039). The central foveal thickness in DME (FA) eyes was significantly lower than that in eyes with DME (OCT) ( = 0.014). After adjusting for age and sex, a logistic regression analysis showed that the classification of diabetic retinopathy in FA was positively associated with macular leakage in FA ( < 0.001). The severity of diabetic retinopathy is underestimated in CFI compared with that in FA. FA can detect latent DMEs, which appeared normal on OCT. The central foveal thickness is not a sensitive parameter for detecting latent DMEs.

摘要

比较光学相干断层扫描（OCT）和荧光素血管造影（FA）在糖尿病性黄斑水肿（DME）中的检出率以及彩色眼底图像（CFI）和FA中糖尿病视网膜病变的严重程度，并研究FA中黄斑渗漏的预测因素。这是一项回顾性研究，共纳入77例糖尿病视网膜病变患者的132只眼。对黄斑OCT、FA和CFI进行了检查和测量。还测量了中心凹厚度。FA中糖尿病视网膜病变的严重程度显著高于CFI（<0.001）。OCT检测出26只患有DME的眼睛，其中包括：13只患有黄斑囊样水肿的眼睛；13只患有浆液性视网膜脱离的眼睛；11只患有弥漫性视网膜增厚的眼睛；4只患有玻璃体黄斑界面异常的眼睛。相比之下，132只眼中有72只（54.5%）在FA中显示黄斑渗漏，显著高于OCT检测出的比例（<0.001）。与FA相比，OCT检测DME的敏感性和特异性分别为30.6%和93.3%。然而，非临床显著性黄斑水肿（CSME，253.1±26.95μm）和轻度CSME（270.9±37.11μm）患者的中心凹厚度无显著差异（=0.204）。糖尿病性黄斑水肿（FA）眼的平均中心凹厚度为271.8±66.02μm，显著高于非DME（FA）眼（253.±25.21μm）（=0.039）。DME（FA）眼的中心凹厚度显著低于DME（OCT）眼（=0.014）。在调整年龄和性别后，逻辑回归分析显示FA中糖尿病视网膜病变的分级与FA中的黄斑渗漏呈正相关（<0.001）。与FA相比，CFI中糖尿病视网膜病变的严重程度被低估。FA可以检测出在OCT上看似正常的潜在DME。中心凹厚度不是检测潜在DME的敏感参数。