糖尿病患者白内障术后黄斑区视网膜厚度和血-房水屏障改变

Macular thickness change and blood-aqueous barrier disorders after cataract surgery in diabetic patients

目的定量检测糖尿病患者白内障术前和术后不同时期黄斑区视网膜厚度和前房水蛋白浓度,探讨其相互关系。方法分别采用光学相干断层扫描仪测量32例32眼糖尿病患者黄斑中心区视网膜厚度值,采用激光闪辉细胞计量仪测量前房平均闪辉计数值。结果术前1d、术后1d、3d、7d和30d时前房平均闪辉计数值分别为3.63pc·ms-1、29.54pc·ms-1、18·12pc·ms-1、10.68pc·ms-1和7.28pc·ms-1,黄斑中心区视网膜厚度分别为167.73μm、266.81μm、274.84μm、216.81μm和187.00μm。影响术后1d、7d和30d时黄斑中心区视网膜厚度的的独立因素都仅为前房平均闪辉计数值。结论糖尿病眼白内障术后血-房水屏障破坏先于黄斑区视网膜厚度改变而达到顶峰。采用前房闪辉计数值监测可以辅助判断糖尿病黄斑水肿的病程进展和治疗效果。

Objective To quantitively evaluate the change of macular thickness and anterior chamber protein values in diabetic patients before and after uneventful cataract surgery. Methods Thirtytwo eyes in 32 diabetic patients were enrolled in this study. The macular thickness were measured using optical coherence tomography, while the average aqueous flare photon counts were measured using Laser flare cell meter at the same time. Results The average aqueous flare photon counts before and 1 day,3 days,7 days,30 days after surgery were 3.63 pc· ms^-1,29.54 pc· ms^-1,18.12 pc· ms^-1,10.68 pc· ms^-1 and 7.28 pc· ms^-1 respectively, and the macular foveola thickness at that time were 167.73 μm, 266.81 μm, 274. 84 μm, 216. 81μm and 187.00 μm. The average aqueous flare photon counts was confirmed as the only independent influence factor of average macular thickness at 1 day, 7 days and 30 days postoperatively. Conclusion The blood-aqueous barrier disorders achieve the acme prior to the macular thickness change after cataract surgery. The aqueous flare photon counts may help in evaluate the disease course and treatment effects of diabetic macular edema.