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1 型糖尿病患儿无视网膜病变时脉络膜厚度和脉络膜血流指数的变化。

Choroidal thickness and choroidal vascularity index changes in children with type 1 diabetes mellitus without retinopathy.

机构信息

Department of Ophthalmology, Faculty of Medicine, Hitit University, Çorum, Turkey.

Department of Ophthalmology, Faculty of Medicine, Hitit University, Çorum, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2023 Sep;43:103706. doi: 10.1016/j.pdpdt.2023.103706. Epub 2023 Jul 14.

Abstract

BACKGROUND

Diabetic retinopathy is one of the most important causes of low vision in the working age group. Retinopathy findings start earlier and have a worse prognosis in type 1 DM. The aim of the this study was to compare the choroidal thickness (CT) and choroidal vascular index (CVI) values of type 1 diabetes mellitus (DM) patients without retinopathy findings in pediatric patients and healthy children.

METHODS

The study included 89 children, including 43 type 1 DM patients and 46 healthy controls. The age, gender, duration of DM, hemoglobin A1c (HbA1c), refractive error, intraocular pressure (IOP) and axial length (AL) of the participants were noted. CT measurements were performed subfoveally, 1000 µm from the fovea in the nasal and temporal quadrants. The total choroidal area (TCA), luminal area (LA) and stromal area (SA) were calculated using the binarization method using the image J program. The CVI was determined by dividing the luminal area by the total choroidal area.

RESULTS

There were no significant differences between the participants in terms of age, gender, spherical equivalent, IOP, and AL. There was no significant difference between the groups in terms of CT. TCA, LA and SA values were significantly higher in the Type 1 DM group (p=0.034, p=0.036, p=0.037, respectively). There was no significant difference between the groups in terms of the CVI.

CONCLUSIONS

The TCA, LA, and SA values were significantly higher in the type 1 DM group. LA/SA and CVI values were lower in the type 1 DM group, although not significantly. There was a negative correlation between the duration of DM and LA/SA as well as CVI. This suggests that vascular reduction starts in the early stages.

摘要

背景

糖尿病视网膜病变是工作年龄段人群低视力的最重要原因之一。1 型糖尿病的视网膜病变发现更早,预后更差。本研究旨在比较无视网膜病变的 1 型糖尿病患儿和健康儿童的脉络膜厚度(CT)和脉络膜血管指数(CVI)值。

方法

该研究纳入 89 名儿童,包括 43 名 1 型糖尿病患者和 46 名健康对照者。记录参与者的年龄、性别、糖尿病病程、糖化血红蛋白(HbA1c)、屈光不正、眼内压(IOP)和眼轴(AL)。在黄斑下、鼻侧和颞侧距黄斑 1000µm 处进行 CT 测量。使用 Image J 程序的二值化方法计算总脉络膜面积(TCA)、管腔面积(LA)和基质面积(SA)。通过将管腔面积除以总脉络膜面积来确定 CVI。

结果

参与者在年龄、性别、等效球镜、IOP 和 AL 方面无显著差异。两组间 CT 无显著差异。1 型糖尿病组 TCA、LA 和 SA 值显著升高(分别为 p=0.034、p=0.036、p=0.037)。两组间 CVI 无显著差异。

结论

1 型糖尿病组 TCA、LA 和 SA 值显著升高。尽管 LA/SA 和 CVI 值在 1 型糖尿病组中较低,但无统计学意义。DM 病程与 LA/SA 和 CVI 呈负相关。这表明血管减少始于早期。

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