糖尿病前期和糖尿病视网膜病变临床前期的视网膜改变

Retinal changes in pre-diabetes and pre-clinic diabetes retinopathy

糖尿病视网膜病变(diabetic retinopathy,DR)是世界范围内劳动年龄人口视力损伤的主要原因。糖尿病前期和DR临床前期患者作为罹患DR的高危人群,在该阶段可发现视网膜神经元形态功能及视网膜微小血管的改变。视网膜及神经纤维层厚度的变化可部分反映视网膜神经元结构改变;色觉、对比敏感度、视野及视觉电生理等变化可反映视网膜神经元功能改变。随着光学相关断层扫描血管成像技术的发展,临床可以检测出DR之前视网膜微血管的改变。此外,许多生物标志物也可以预测和评估DR。由于目前还没有方法可以阻止DR的发生与进展,临床可以通过观察以上视网膜的改变更为及时地发现DR,以降低其患病率,最大限度地减少DR带来的视力损伤。

Diabetes retinopathy(DR)is the main cause of visual impairment in the working population worldwide.Patients with pre-diabetes and pre-clinic diabetic retinopathy are regarded as in high risk group of DR.The changes in morphology and function of renal neurons and retinal micro-vessels can be found in these patients at this stage.The changes of retinal nerve structure can be partly reflected by changes in the thickness of retina and nerve fiber layer.The changes in function of retinal neurons can be reflected by changes in color vision,contrast sensitivity,visual field and visual electrophysiology With the development of optical coherence tomography angiography,changes in retinal micro-vessels can be observed prior to clinical detection of DR.In addition,many biomarkers can also predict and evaluate DR.Since there is no way to prevent the occurrence and progress of DR at present,more attention should be paid in DR by observing the changes in the retina mentioned above timely,to reduce its incidence and minimize the visual damage caused by DR.