近视性屈光不正与糖尿病视网膜病变的关系

RELATIONSHIP OF MYOPIA AND DIABETIC RETINOPATHY

目的评价近视性屈光不正与糖尿病视网膜病变(DR)程度的关系,并探讨其发生的原因。方法按照屈光不正程度将2型糖尿病病人的190只眼分为3组:正视~<-3.0 D(102只眼),-3.0^-6.0 D(56只眼),>-6.0 D(32只眼)。采用国际标准视力表检查视力;使用裂隙灯显微镜检查眼前节,托品酰胺眼液散瞳(排除高眼压后)双目间接检眼镜检查眼底。DR分期分为无DR、DR背景期和DR增殖期。结果近视程度越高,DR病变程度反而越轻,差异有显著性(Hc=71.19,q=19.68~27.12,P<0.01)。结论近视程度较高时,视网膜动脉系统的血流减少,DR病变程度减轻。

Objective To evaluate the relationship of myopia and diabetic retinopathy and to explore their pathogenic causes. Methods Eyes of the diabetic patients （n=190） were divided into 3 groups according to the degree of refraction error： 〈-3.0D （emmetropia, n= 102）,-3.0-- 6.0D （n=56）,〉-6.0D （n=32）. Vision examination by international standard visual acuity chart and anterior segment of the eye by slit lamp microscope were also performed. A binocular indirect ophthalmoscope was employed to examine the fundus oculi after pupil dilation by bistropamide. Rank sum test was proceeded on the degree of refraction error and DR stages. Results DR was divided into three stages： no DR, background stage and proliferating stage. The degree of refraction error and DR stages were negatively correlated, the higher the myopia diopters, the slighter the DR degree, the differences between them were statistically significant （Hc=71.19, q=19. 68-27. 12, P〈0. 01）. Conclusion Patients with higher myopia will have lower blood pressure in the central retinal artery which relieves diabetic retinopathy.