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与增生型糖尿病性视网膜病变患者糖尿病性黄斑水肿相关的因素。

Factors associated with diabetic macular edema in patients with proliferative diabetic retinopathy.

机构信息

Department of Ophthalmology, Keck School of Medicine, USC Roski Eye Institute, University of Southern California, 1450 San Pablo St., Suite 4703, Los Angeles, CA, 90033, USA.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2022 Jul;260(7):2191-2200. doi: 10.1007/s00417-022-05595-9. Epub 2022 Feb 22.

Abstract

PURPOSE

To identify factors associated with diabetic macular edema (DME) and to characterize the types of DME present in eyes with proliferative diabetic retinopathy (PDR).

METHODS

Observational, retrospective case series of PDR patients reviewed for demographic information, general medical history, ophthalmologic history, optical coherence tomography (OCT), and fluorescein angiogram image characteristics. DME and vitreomacular interface (VMI) status were determined using OCT images. DME was defined as center-involving DME (CI-DME) and noncenter-involving DME (NCI-DME). VMI was defined as vitreomacular adhesion (VMA), vitreomacular traction (VMT), or macular posterior vitreous detachment (PVD).

RESULTS

A total of 293 eyes of 210 screened patients with PDR were included. Of the eyes, 194/293 (66.2%) had DME, and 99/293 (33.8%) had no DME; in univariable analysis, there were no significant differences in VMI status (p = 0.4) or epiretinal membrane (ERM, p = 0.1) between them. Of 194 eyes with DME, 90/194 (46.4%) had CI-DME, and 104/194 (53.6%) had NCI-DME. In univariable analysis, CI-DME eyes were significantly more likely than NCI-DME eyes to have a PVD (p = 0.029) and ERM (p < 0.001). In multivariable analysis, the presence of younger age (p = 0.028) and presence of ERM (p = 0.001) were significantly more likely to be observed in eyes with CI-DME.

CONCLUSION

In this exploratory study focused on diabetic patients with PDR, we determined that VMI status did not have a significant association with DME in general, but VMI status, younger age, and presence of ERM may be associated with CI-DME.

摘要

目的

确定与糖尿病黄斑水肿(DME)相关的因素,并描述增殖性糖尿病视网膜病变(PDR)患者眼中存在的 DME 类型。

方法

对 PDR 患者进行回顾性观察性病例系列研究,以获取人口统计学信息、一般病史、眼科病史、光学相干断层扫描(OCT)和荧光素血管造影图像特征。使用 OCT 图像确定 DME 和玻璃体黄斑界面(VMI)状态。DME 定义为中心累及 DME(CI-DME)和非中心累及 DME(NCI-DME)。VMI 定义为玻璃体黄斑粘连(VMA)、玻璃体黄斑牵引(VMT)或黄斑后玻璃体脱离(PVD)。

结果

共纳入 210 例 PDR 筛查患者的 293 只眼。其中 194/293(66.2%)只眼患有 DME,99/293(33.8%)只眼无 DME;在单变量分析中,VMI 状态(p=0.4)或视网膜前膜(ERM,p=0.1)在两组间无显著差异。在 194 只患有 DME 的眼中,90/194(46.4%)只眼为 CI-DME,104/194(53.6%)只眼为 NCI-DME。在单变量分析中,CI-DME 眼比 NCI-DME 眼更有可能出现 PVD(p=0.029)和 ERM(p<0.001)。多变量分析显示,年龄较小(p=0.028)和存在 ERM(p=0.001)更有可能出现在 CI-DME 眼中。

结论

在这项针对 PDR 糖尿病患者的探索性研究中,我们确定 VMI 状态与一般 DME 没有显著关联,但 VMI 状态、年龄较小和存在 ERM 可能与 CI-DME 相关。

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