Sander B, Larsen M, Engler C, Lund-Andersen H, Parving H H
Department of Ophthalmology, Gentofte Hospital, University of Copenhagen, Denmark.
Acta Ophthalmol (Copenh). 1994 Oct;72(5):553-9. doi: 10.1111/j.1755-3768.1994.tb07179.x.
In diabetic retinopathy capillary loss and blood-retina barrier leakage are prominent factors. We present a study with quantitative measurements of both capillary loss and leakage and their relation to cumulative metabolic control. Seventeen insulin-dependent diabetic patients with no retinopathy or only mild background retinopathy and 10 years' duration of the disease were included in the study. Status of metabolic regulation had been followed for at least 6 years. Seven healthy subjects were included as controls. In diabetic patients the perifoveal intervascular areas were found to increase significantly with the cumulative HbA1c index (p = 0.02) and in relation to the presence of moderate background retinopathy (p < 0.02). The blood-retina barrier leakage and the area of the foveal avascular zone were not significantly different from healthy subjects and no correlation was found between the HbA1c index and blood-retina barrier permeability. We conclude that perifoveal capillary loss occurs early in the course of diabetic retinopathy and that this loss is related to prior glycemic control and to the ophthalmoscopic retinopathy level.
在糖尿病视网膜病变中，毛细血管丧失和血视网膜屏障渗漏是突出因素。我们开展了一项研究，对毛细血管丧失和渗漏及其与累积代谢控制的关系进行了定量测量。该研究纳入了17名胰岛素依赖型糖尿病患者，他们没有视网膜病变或仅有轻度背景性视网膜病变，病程为10年。代谢调节状态已跟踪至少6年。纳入7名健康受试者作为对照。在糖尿病患者中，发现中央凹周围血管间区域随累积糖化血红蛋白指数显著增加（p = 0.02），且与中度背景性视网膜病变的存在有关（p < 0.02）。血视网膜屏障渗漏和黄斑无血管区面积与健康受试者无显著差异，且未发现糖化血红蛋白指数与血视网膜屏障通透性之间存在相关性。我们得出结论，中央凹周围毛细血管丧失在糖尿病视网膜病变病程早期就会发生，且这种丧失与既往血糖控制及眼底视网膜病变程度有关。
