Larsson L I, Pach J M, Brubaker R F
Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA.
Am J Ophthalmol. 1995 Sep;120(3):362-7. doi: 10.1016/s0002-9394(14)72166-x.
We measured aqueous dynamic variables in subjects with diabetes mellitus and correlated them with severity of retinopathy and metabolic control to determine whether diabetes affects the anterior circulation of the eye as it affects the posterior (retinal) circulation.
Sixty-one subjects with diabetes mellitus type 1 and 60 subjects with diabetes mellitus type 2 were recruited from the active practice of the Mayo Clinic. Thirty-two normal subjects, divided by age into two overlapping groups of 20 each, served as contemporaneous control subjects. The diabetic subjects were stratified into four groups according to severity of retinopathy. Aqueous humor flow was measured by clearance of topically applied fluorescein with a spectrofluorophotometer; outflow facility was measured by tonography; and intraocular pressure was measured by applanation tonometry.
In type 1 diabetics, the mean intraocular pressure was slightly greater (14 +/- 3 mm Hg), compared with control subjects (12 +/- 2 mm Hg [P = .002]), while aqueous humor flow was slightly less (2.5 +/- 0.6 microliter/min), compared with control subjects (2.9 +/- 0.5 microliter/min [P = .023]). In type 2 diabetics, the intraocular pressure was 14 +/- 3 mm Hg, which did not differ from that of control subjects (14 +/- 3 mm Hg [P = .258]). Aqueous humor flow in type 2 diabetics (2.5 +/- 0.7 microliter/min) did not differ significantly from that of the control group (2.5 +/- 0.7 microliter/min [P = .961]). Tonographic facility of outflow was not significantly different in type 1 and type 2 diabetics and the control subjects. There was no significant correlation in aqueous humor flow, intraocular pressure, or tonographic facility of outflow to severity of retinopathy or hemoglobin A1c in either type 1 or type 2 diabetics.
The dynamics of aqueous humor are not affected to any clinically significant extent in the early or middle stages of diabetic retinopathy. However, there is a tendency toward less aqueous humor flow in the advanced stages of retinopathy.
我们测量了糖尿病患者的房水动力学变量，并将其与视网膜病变的严重程度和代谢控制情况相关联，以确定糖尿病是否会像影响后段（视网膜）循环一样影响眼前段循环。
从梅奥诊所的门诊中招募了61例1型糖尿病患者和60例2型糖尿病患者。32名正常受试者按年龄分为两组，每组20名，作为同期对照。糖尿病患者根据视网膜病变的严重程度分为四组。房水流量通过用分光荧光光度计测量局部应用荧光素的清除率来测定；房水流畅度通过眼压描记法测量；眼压通过压平眼压计测量。
1型糖尿病患者的平均眼压略高于对照组（14±3 mmHg对比对照组的12±2 mmHg [P = 0.002]），而房水流量略低于对照组（2.5±0.6微升/分钟对比对照组的2.9±0.5微升/分钟 [P = 0.023]）。2型糖尿病患者的眼压为14±3 mmHg，与对照组无差异（14±3 mmHg [P = 0.258]）。2型糖尿病患者的房水流量（2.5±0.7微升/分钟）与对照组无显著差异（2.5±0.7微升/分钟 [P = 0.961]）。1型和2型糖尿病患者及对照组的眼压描记房水流畅度无显著差异。在1型或2型糖尿病患者中，房水流量、眼压或眼压描记房水流畅度与视网膜病变严重程度或糖化血红蛋白均无显著相关性。
在糖尿病视网膜病变的早期或中期，房水动力学未受到任何具有临床意义的影响。然而，在视网膜病变的晚期，房水流量有减少的趋势。
