Menon S R, Dekker P, Robert Y
Augenklinik Universitätsspital Zürich.
Klin Monbl Augenheilkd. 1996 May;208(5):275-8. doi: 10.1055/s-2008-1035213.
The yellowing is a precursor of the cataract. In the diabetic patient this phenomenon is established earlier than in normal control groups. In the literature the yellowing is explained by elevated glucose levels. Does the duration of diabetes play a key role for this phenomenon?
The yellowing of the lens can be very well detected by the ocular photometer. Using this device, 52 well regulated diabetics without retinopathy and 19 diabetics with mild background retinopathy were examined. We determined the contrast-transfer ratio of the lens, which has been correlated with the age, the duration of diabetes, the weight of the patient, the bodymass index and the hemoglobin a1c of the patient.
Without retinopathy none of the introduced correlations were significant. If the diabetes is well regulated, even a long duration of diabetes does not cause any yellowing of the lens. With mild retinopathy the yellowing of the lens could not be detected because of the sites of measurement, which were changing. A high correlation between the duration of diabetes and the intensity of the macula and the excavation has been found. The macula gets darker and the excavation gets brighter.
The yellowing of the lens does not depend on any of the presented parameters. In diabetics with mild background retinopathy the macula gets darker. This can be interpreted as an hyperemia of the choroid. Most probably this phenomenon is caused by the decline of sympathetic nerve fibers.
晶状体变黄是白内障的先兆。在糖尿病患者中,这种现象比正常对照组出现得更早。文献中认为晶状体变黄是由血糖水平升高所致。糖尿病病程对这一现象是否起关键作用呢?
晶状体变黄可通过眼光度计很好地检测出来。利用该设备,对52名病情控制良好且无视网膜病变的糖尿病患者以及19名患有轻度背景性视网膜病变的糖尿病患者进行了检查。我们测定了晶状体的对比度传递率,并将其与患者的年龄、糖尿病病程、体重、体重指数及糖化血红蛋白进行了关联分析。
在无视网膜病变的患者中,所引入的关联均无显著意义。如果糖尿病病情控制良好,即使病程较长也不会导致晶状体变黄。对于患有轻度视网膜病变的患者,由于测量部位不断变化,未能检测到晶状体变黄。已发现糖尿病病程与黄斑强度及凹陷之间存在高度相关性。黄斑变得更暗,凹陷变得更亮。
晶状体变黄不取决于所提及的任何参数。在患有轻度背景性视网膜病变的糖尿病患者中,黄斑会变得更暗。这可解释为脉络膜充血。很可能这种现象是由交感神经纤维减少引起的。