Arruabarrena Carolina, Rodríguez-Miguel Antonio, de Aragón-Gómez Fernando, Escámez Purificación, Rosado Ingrid, Teus Miguel A
Retina Unit, Department of Ophthalmology, University Hospital "Príncipe de Asturias", 28805 Alcalá de Henares, Madrid, Spain.
Department of Biomedical Sciences, University of Alcalá (IRYCIS), 28805 Alcalá de Henares, Madrid, Spain.
J Clin Med. 2023 Aug 11;12(16):5232. doi: 10.3390/jcm12165232.
The purpose was to establish normative data for the macular thicknesses and volume using spectral-domain optical coherence tomography (SD-OCT) in a diabetic population without maculopathies for use as a reference in diabetic retinopathy (DR) and diabetic macular edema screening programs.
This was an observational study nested in a cohort of diabetics from a telemedicine DR screening program. Each patient underwent SD-OCT centered on the fovea. Macular thickness and volume were described and compared using the built-in normative database of the device. Quantile regression models for the 97.5% percentile were fitted to evaluate the predictors of macular thickness and volume.
A total of 3410 eyes (mean age, 62.25 (SD, 0.22) years) were included. Mean (SD) central subfield thickness (CST) was 238.2 (23.7) µm, while center thickness (CT), average thickness (AT), and macular volume (MV) were 205.4 (31.6) µm, 263.9 (14.3) µm, and 7.46 (0.40) mm, respectively. Para- and perifoveal thicknesses were clinically and statistically significantly thinner in our population than in the normative reference database. The 97.5% percentile of the thickness of all sectors was increased in males and in the para- and perifovea among those with DR.
All ETDRS sectors were thinner in patients with diabetes than in the reference population, except for the CST, which was the most stable parameter that only changed with sex. The upper cutoff limit to detect diabetic macular edema (DME) was different from that of the reference population and was influenced by conditions related to diabetes, such as DR. Therefore, specific normative data for diabetic patients should be used for the screening and diagnosis of DME using SD-OCT.
本研究旨在利用光谱域光学相干断层扫描(SD-OCT)为无黄斑病变的糖尿病患者建立黄斑厚度和体积的规范数据,以供糖尿病视网膜病变(DR)和糖尿病性黄斑水肿筛查项目作为参考。
这是一项嵌套于远程医疗DR筛查项目糖尿病队列中的观察性研究。每位患者均接受以黄斑中心凹为中心的SD-OCT检查。使用设备内置的规范数据库描述并比较黄斑厚度和体积。拟合97.5%百分位数的分位数回归模型,以评估黄斑厚度和体积的预测因素。
共纳入3410只眼(平均年龄62.25(标准差0.22)岁)。平均(标准差)中心子区域厚度(CST)为238.2(23.7)µm,而中心厚度(CT)、平均厚度(AT)和黄斑体积(MV)分别为205.4(31.6)µm、263.9(14.3)µm和7.46(0.40)mm³。我们研究人群的旁黄斑和黄斑周围厚度在临床和统计学上均显著薄于规范参考数据库中的数据。男性以及患有DR的人群中旁黄斑和黄斑周围区域的所有扇区厚度的97.5%百分位数均有所增加。
糖尿病患者所有ETDRS扇区均比参考人群薄,但CST除外,CST是最稳定的参数,仅随性别变化。检测糖尿病性黄斑水肿(DME)的上限与参考人群不同,且受糖尿病相关情况(如DR)的影响。因此,使用SD-OCT筛查和诊断DME时应采用糖尿病患者的特定规范数据。