频域OCT对无糖尿病视网膜病变的2型糖尿病患者视网膜神经纤维层厚度的研究

The Research to the thickness of retinal nerve fiber layer by spectral domain OCT in type II diabetes mellitus patients without diabetic retinopathy

目的观察无糖尿病视网膜病变(NDR)的2型糖尿病(T2DM)患者视乳头和黄斑区视网膜神经纤维层厚度的改变。方法收集2型糖尿病患者30例和年龄及性别相匹配的健康对照组30例,利用频域OCT视乳头扫描模式测量患者双眼视乳头、黄斑区视网膜神经纤维层(RNFL)厚度。所有数据采用成组设计的t检验进行统计学处理。结果NDR组视乳头上方RNFL较对照组变薄,差异有统计学意义(P=0.007),视乳头鼻侧、下方和颞侧RNFL在两组间差异无统计学意义(P=0.451,0.210,0.653)。NDR组黄斑上方RNFL较对照组变薄,差异有统计学意义(P=0.021),下方、鼻侧及颞侧RNFL在两组间差异无统计学意义(P=0.341,0.561,0.231)。结论在NDR的T2DM患者中,无论视乳头还是黄斑区均出现RNFL变薄,且其变化早于视网膜微血管病变。

Objective To observe the change of the retinal nerve fiber layer thickness in type 2 diabetes mellitus(TDM2)patients without diabetic retinopathy(DR).Methods Thirty TDM2 patients with no DR(NDR)and 30 normal age-and sex-matched controls were recruited in our study.They underwent complete examinations that included super field color fundus photography and spectral-domain optical coherence tomography(OCT).The OCT patterns were used to measure the retinal fiber layer thickness(RNFL)of macular and around the optic disc.All results were compared between NDR group and control group.The difference among the group was assessed by t test.Results The superior RNFL around optic nerve was statistically thinner in NDR group than control group(P=0.07).There was no statistical difference in the inferior,temporal and nasal RNFL around optic disc(P=0.451,0.210,0.653).In fovea,the superior RNFL was thinner in NDR group(P=0.021).Conclusions In TDM2 patients without DR,the superior RNFL both around optic disc and fovea were thinner.And neurodegenerative changes occur in the absence of vascular changes.