糖尿病黄斑水肿患者椭圆体带完整性与视力的相关性研究

Association between elipsode zone integrity and visual acuity in diabetic macular edema

目的:探讨糖尿病黄斑水肿(diabetic macular edema,DME)患者视力与椭圆体带完整性的相关性及视力的相关影响因素。方法:纳入糖尿病视网膜病变(diabetic retinopathy,DR)合并DME患者39例62眼,根据频域光学相干断层扫描(spectral domain optical coherence tomography,SD-OCT)技术测量的椭圆体带破坏程度进行分组:A组椭圆体带完整连续,B组椭圆体带缺损长度≤200μm,C组椭圆体带缺损长度>200μm。测量三组患者的最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心凹视网膜厚度(central macular thickness,CMT),观察是否存在浆液性视网膜脱离(serous retinal detachment,SRD)和硬性渗出(hard exudates,HE)等。采用Pearson相关法分析年龄、性别、糖尿病病程、HbA1c、DME病程和类型、DR分期、椭圆体带缺损长度、是否存在SRD和HE等因素与BCVA的相关性。结果:治疗前三组患者BCVA分别为0.44±0.18、0.64±0.16、0.74±0.21,差异有统计学意义(P<0.001)。三组患者CMT分别为403.40±90.32、408.44±95.98、421.29±98.32μm,差异无统计学意义(P=0.805)。Pearson相关分析提示,椭圆体带缺损长度、CMT均与BCVA呈负相关(r=-0.673、-0.344,均P<0.001),且椭圆体带缺损长度与BCVA呈强相关,CMT与BCVA呈弱相关,其它因素如SRD、HE、DME病程等均与BCVA无明显相关性。结论:椭圆体带的完整性与BCVA存在较强的相关性,CMT与BCVA存在弱相关性。

·AIM:To investigate the correlation between elipsode zone(EZ)integrity and best corrected visual acuity(BCVA)of eyes with diabetic macular edema(DME),and to determine the prognostic factors of visual acuity.·METHODS:We studied 62 eyes of 39 patients with DME.Using spectral domain optical coherence tomography(SD-OCT),disrupted elipsode zone length were measured,and the eyes were categorized into three groups according to elipsode zone:1)Group A:with a completely visible elipsode zone;2)Group B:with a disrupted elipsode zone and the length of disruption within 200μm;(3)Group C:with a disrupted elipsode zone and the length of disruption longer than 200μm.We also evaluated the presence or absence of hard exudates(HE),serous retinal detachment(SRD),central macular thickness(CMT)using SD-OCT.Pearson analysis testing was performed over the BCVA and the elipsode zone integrity,CMT,existence of SRD and HE,age,sex,duration of diabetes,HbA1c,duration of DME,stage of diabetic retinopathy,and DME type.·RESULTS:Before treatment,BCVA(LogMAR)in the Group A(0.44±0.18)or Group B(0.64±0.16)was significantly better than that in the Group C(0.74±0.21)(P<0.001).CMT had no difference between Group A(403.40±90.32μm),Group B(408.44±95.98μm)or Group C(421.29±98.32μm,P=0.805).Analysis showed that elipsode zone integrity had close correlation coefficient with BCVA(r=-0.673,P<0.001),CMT had weak correlation with BCVA(r=-0.344,P<0.001).Other factors SRD,HE and duration of DME did not correlate with BCVA.·CONCLUSION:The integrity of elipsode zone are closely associated with BCVA in DME.CMT are weakly associated with BCVA in DME.