中华眼底病杂志

中华眼底病杂志

糖尿病黄斑水肿患眼黄斑区视功能与黄斑中心凹视网膜厚度的相关性分析

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目的 观察探讨糖尿病黄斑水肿(DME)患眼黄斑区视功能与黄斑中心凹视网膜厚度(CRT)的相关性。 方法 前瞻性、无对照、开放性研究。临床确诊为DME的24例患者40只眼纳入研究。其中,男性10例18只眼,女性14例22只眼。年龄41~79岁,平均年龄(56.84±8.96)岁。均为2型糖尿病患者,平均糖尿病病程8年。所有患眼均采用国际标准Snellen E字母视力表测量最佳矫正视力(BCVA),统计分析时将其转换为最小分辨角对数(logMAR)视力。采用Cirrus HD-OCT4000测量CRT。采用MAIA微视野计测量黄斑区视网膜敏感度(AT),黄斑完整性指数(MI),1°(P1)和2°(P2)半径注视点百分比,由63%、95%注视点组成的二元椭圆形区域周线(BCEA)面积A63、A95,BCEA的水平轴线H63、H95和垂直轴线V63、V95。采用Pearson相关性分析法分析logMAR BCVA、CRT与微视野参数的相关性。采用多元线性回归分析影响固视类型的独立因素。 结果 Pearson相关性分析结果显示,logMAR BCVA与CRT(r=0.58,P=0.000)、V63(r=0.44,P=0.004)、V95(r=0.41,P=0.008)、MI(r=0.36,P=0.024)呈正相关,与AT(r=−0.61,P=0.000)、P1(r=−0.41,P=0.009)、P2(r=−0.38,P=0.015)呈负相关。AT与P1(r=0.53,P=0.000)、P2(r=0.51,P=0.001)呈正相关,与A63(r=−0.39,P=0.012)、A95(r=−0.40,P=0.012)、V63(r=−0.53,P=0.000)、V95(r=−0.46,P=0.003)、MI(r=−0.50,P=0.001)呈负相关;与CRT无相关性(r=−0.21,P=0.190)。40只眼中,固视稳定8只眼,占20%;固视相对不稳定14只眼,占35%;固视不稳定18只眼,占45%。多元线性回归分析结果显示,P1是影响固视类型的独立因素。 结论 DME患眼logMAR BCVA与CRT呈正相关,与AT、P1、P2呈负相关;AT与CRT无相关性。P1是影响DME患眼固视类型的独立因素。

Objective To investigate the correlation of microperimetric parameters, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in diabetic macular edema (DME) eyes. Methods It is a prospective, no controlled, open study. Twenty-four consecutive patients (40 eyes) with DME were included. There were 10 males (18 eyes),14 females (22 eyes); aged from 41 to 79 years, with the mean age of (56.84±8.96) years. All the patients were type 2 diabetes, the average duration of diabetes was 8 years. BCVA was evaluated using the international Snellen E vision test chart, and then recorded as logarithm of the minimum angle of resolution (logMAR). CRT was measured by Cirrus HD-OCT4000. MAIA microperimetric parameters were evaluated, including average threshold (AT) of retinal sensitivity, macular integrity index (MI), fixating points within a circle of 1° (P1) and 2° of radius (P2), bivariate contour ellipse area (BCEA) considering 63% and 95% of fixating points (A63,A95), and horizontal and vertical axes of that ellipse (H63,H95,V63,V95). Pearson correlation analysis was performed to evaluate the association between these variables. The independent factor influenced the type of fixation was analyzed by multiple linear regression analysis. Results Strong correlations of logMAR BCVA with CRT (r=0.58,P=0.000), V63 (r=0.44,P=0.004), V95 (r=0.41,P=0.008), MI (r=0.36,P=0.024), AT (r=−0.61,P=0.000), P1 (r=−0.41,P=0.009), P2 (r=−0.38,P=0.015) were found. AT was correlations with P1 (r=0.53,P=0.000), P2 (r=0.51,P=0.001), A63 (r=−0.39,P=0.012), A95 (r=−0.40,P=0.012), V63 (r=−0.53,P=0.000), V95 (r=−0.46,P=0.003), MI (r=−0.50,P=0.001). There was no correlation between AT and CRT (r=−0.21,P=0.190). Forty eyes were included in this study, 8 eyes (20%) had stable fixation,14 eyes (35%) had relatively unstable fixation,18 eyes (45%) had unstable fixation. Multiple linear regression analysis showed that fixation classification was independently affected by P1. Conclusions In DME eyes, logMAR BCVA was positively correlated with CRT, negatively correlated with AT, P1 and P2. There is no correlation between AT and CRT. The fixation classification was independently affected by P1.

关键词: 糖尿病视网膜病变/并发症; 黄斑水肿; 视野; 视网膜/病理生理学; 体层摄影术,光学相干

Key words: Diabetic retinopathy/complications; Macular edema; Visual fields; Retina/ physiopathology; Tomography, optical coherence

引用本文: 王建伟, 接传红, 陶永健, 吴正正, 张红. 糖尿病黄斑水肿患眼黄斑区视功能与黄斑中心凹视网膜厚度的相关性分析. 中华眼底病杂志, 2017, 33(3): 267-270. doi: 10.3760/cma.j.issn.1005-1015.2017.03.011 复制

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