Storch Marcus Werner, Zinser Greta, Lauermann Peer, Khattab Mohammed Haitham, Nguyen-Höhl Anna, Raddatz Dirk, Gollisch Katja, Callizo Josep, Hoerauf Hans, Feltgen Nicolas
Department of Ophthalmology, University of Göttingen, Göttingen, Niedersachsen, Germany.
Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University of Göttingen, Göttingen, Niedersachsen, Germany.
Clin Ophthalmol. 2022 Apr 21;16:1207-1213. doi: 10.2147/OPTH.S358467. eCollection 2022.
To correlate functional and morphological parameters with foveal avascular zone's (FAZ) size in diabetic patients with mild to moderate stage nonproliferative diabetic retinopathy.
Monocentric and prospective study of a consecutive case series of diabetic patients. Medical history, best corrected visual acuity (BCVA), best corrected high/low contrast visual acuity (BChcVA/BClcVA), mean sensitivity (MS) and mean defect (MD) in central visual field testing, and FAZ size in fluorescein-angiography (FAG) were recorded. Macular thickness (central point thickness CPT, central subfield thickness CST) and volume measurements (central subfield volume CSV, total macular volume) were taken from SD-OCT (6x6mm ETDRS-grid). Groups were categorised as presenting FAZ sizes smaller (G1) or larger (G2) than 0.35mm. Smallest (Q1) and largest quartiles (Q3) were also compared.
Thirty-six of 40 patients were included. MS differed significantly between G1 (n = 6) and G2 (n = 30), and BChcVA/BClcVA as well as TMV correlated significantly with FAZ size in correlation analysis. Mean HbA1c tended to be lower in G1 than G2. Patients in G1 were slightly older than in G2. Treatment period with insulin was shorter in G1/Q1 than in G2/Q3. CPT and TMV were lower in G1/Q1 than in G2/Q3. Our analysis of the FAZ in terms of patient age, HbA1c, disease duration and insulin therapy duration revealed no significance. That lack of significance also applies to BCVA, MS, MD, CPT, CST and CSV.
As significantly associated, contrast sensitivity, central visual field parameters and potentially retinal thickness or volume seem to be suitable to detect early macular ischaemia. However, we failed to establish any correlation between FAZ and BCVA.
将轻度至中度非增殖性糖尿病视网膜病变患者的功能和形态学参数与黄斑无血管区（FAZ）大小进行关联分析。
对糖尿病患者连续病例系列进行单中心前瞻性研究。记录病史、最佳矫正视力（BCVA）、最佳矫正高/低对比度视力（BChcVA/BClcVA）、中心视野检测中的平均敏感度（MS）和平均缺损（MD），以及荧光素血管造影（FAG）中的FAZ大小。通过光谱域光学相干断层扫描（SD-OCT，6×6mm ETDRS网格）测量黄斑厚度（中心点厚度CPT、中心子区域厚度CST）和体积测量值（中心子区域体积CSV、黄斑总体积）。将研究对象分为FAZ大小小于0.35mm的组（G1）和大于0.35mm的组（G2）。同时比较最小四分位数（Q1）和最大四分位数（Q3）。
纳入40例患者中的36例。G1组（n = 6）和G2组（n = 30）的MS存在显著差异，相关性分析显示BChcVA/BClcVA以及总体积（TMV）与FAZ大小显著相关。G1组的平均糖化血红蛋白（HbA1c）倾向于低于G2组。G1组患者比G2组患者年龄稍大。G1/Q1组的胰岛素治疗时间短于G2/Q3组。G1/Q1组的CPT和TMV低于G2/Q3组。我们对FAZ在患者年龄、HbA1c、病程和胰岛素治疗时间方面的分析未发现显著差异。这种不显著也适用于BCVA、MS、MD、CPT、CST和CSV。
由于存在显著相关性，对比敏感度、中心视野参数以及潜在的视网膜厚度或体积似乎适合用于检测早期黄斑缺血。然而，我们未能确定FAZ与BCVA之间的任何相关性。
