2型糖尿病患者视网膜及视神经纤维层厚度变化的研究

Thickness variation of retina and retinal nerve fiber layer in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者未出现糖尿病视网膜病变(DR)前视网膜及视神经纤维层(RNFL)厚度的改变情况。方法应用光学相干断层扫描检测31例(62眼)患者(实验组)及19例(38眼)健康者(对照组)的黄斑区视网膜厚度及黄斑区、视乳头旁RNFL厚度。结果实验组患者视乳头上方RNFL厚度、黄斑区外环及内环上方的RNFL厚度均明显薄于对照组(P<0.05),实验组患者其余视乳头旁各方位及黄斑各分区的RNFL厚度、黄斑区及其各分区的视网膜厚度与正常组比较,差异均无统计学意义(P>0.05)。结论 2型糖尿病患者未并发DR前,部分RNFL厚度已经开始变薄,早期观察2型糖尿病患者视网膜RNFL变化情况,可较早了解患者视网膜病变。

Objective To explore the thickness variation of retina and retinal nerve fiber layer（ RNFL） in patients with type 2 diabetes mellitus before the occurrence of diabetic retinopathy（ DR）. Methods Optical coherence tomography was used to detect the retinal thickness in the macular area,the RNFL thickness in the macular area and peripapillary RNFL thickness in 31 patients（ 62 eyes） with DR（ experimental group） and 19 healthy persons（ 38 eyes）（ control group）. Results Experimental group obtained significantly thinner RNFL thickness above the optic papilla as well as significantly thinner RNFL thickness above of outer ring and inner ring of macular area compared to control group（ P 〈 0. 05）. For the RNFL thickness in other divisions of macular area and other directions of peripapilla,as well as the thickness of retina in the macular area and its divisions,there were no significant differences between two groups（ P 〉 0. 05）. Conclusion Parts of RNFL thickness already get thinner in patients with type 2 diabetes mellitus before the occurrence of DR. An early observation on the changes in RNFL thickness of patients with type 2 diabetes mellitus can get valuable information about diabetic retinopathy in patients at an early stage.