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糖尿病对视网膜前膜手术后短期预后的影响。

The effect of diabetes on short-term outcomes following epiretinal membrane surgery.

作者信息

Hecht Idan, Karesvuo Minna, Kanclerz Piotr, Jeon Sohee, Karesvuo Petteri, Tuuminen Raimo

机构信息

Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland.

Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Int Ophthalmol. 2024 Dec 5;44(1):446. doi: 10.1007/s10792-024-03373-6.

Abstract

PURPOSE

This study aimed to examine the association of diabetes with anatomical and functional outcomes of epiretinal membrane surgery.

METHODS

Consecutive patients who underwent epiretinal membrane surgery between 2017-2021 at Helsinki University Hospital, Finland. Here we examined the association of diabetes, glycemic control, and requirement for insulin medication with surgical outcomes at 1-month.

RESULTS

Included were 214 eyes of 214 patients, with a mean age of 71.2 ± 8.2 years. Among patients with diabetes (n = 45), neither significant differences were observed in anatomical outcomes (- 47.8 ± 72.7 μm vs. - 38.3 ± 103 μm for foveal thickness, p = 0.566 and - 41.6 ± 61.8 μm vs. - 41.7 ± 85.7 μm for central subfield macular thickness, p = 0.996) nor in best-corrected visual acuity (BCVA) gain (0.06 ± 0.22 vs 0.12 ± 0.30 LogMAR units, p = 0.214) compared to those without diabetes. In a multivariate analysis adjusted for age, gender, the existence of preoperative macular cysts, and topical nonsteroidal anti-inflammatory drugs (NSAIDs) use, the results remained consistent. The last preoperative HbA1c levels did not correlate with changes in foveal (Pearson's r = 0.218, p = 0.264) or central subfield macular thickness (r = 0.365, p = 0.056), or with BCVA gain (r = -0.177, p = 0.386). Insulin therapy for diabetes did not associate with the outcomes (p > 0.05 for anatomical and functional comparisons).

CONCLUSIONS

In a cohort of patients who underwent epiretinal membrane surgery, neither the presence of diabetes, nor glycemic control and the use of insulin medication associated with the outcomes.

摘要

目的

本研究旨在探讨糖尿病与视网膜前膜手术的解剖学和功能预后之间的关联。

方法

连续纳入2017年至2021年在芬兰赫尔辛基大学医院接受视网膜前膜手术的患者。在此,我们研究了糖尿病、血糖控制以及胰岛素用药需求与1个月时手术预后的关联。

结果

纳入214例患者的214只眼,平均年龄为71.2±8.2岁。在糖尿病患者(n = 45)中,与非糖尿病患者相比,无论是在解剖学预后方面(黄斑中心凹厚度为-47.8±72.7μm vs. -38.3±103μm,p = 0.566;黄斑中心子区域厚度为-41.6±61.8μm vs. -41.7±85.7μm,p = 0.996),还是在最佳矫正视力(BCVA)提高方面(0.06±0.22 vs 0.12±0.30 LogMAR单位,p = 0.214),均未观察到显著差异。在对年龄、性别、术前黄斑囊肿的存在情况以及局部非甾体抗炎药(NSAIDs)使用情况进行校正的多因素分析中,结果仍然一致。术前最后一次糖化血红蛋白(HbA1c)水平与黄斑中心凹厚度(Pearson相关系数r = 0.218,p = 0.264)或黄斑中心子区域厚度的变化(r = 0.365,p = 0.056),以及与BCVA提高(r = -0.177,p = 0.386)均无相关性。糖尿病的胰岛素治疗与预后无关(解剖学和功能比较的p均>0.05)。

结论

在接受视网膜前膜手术的患者队列中,糖尿病的存在、血糖控制以及胰岛素用药均与预后无关。

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