中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2015年
6期
607-612
,共6页
频域OCT%糖尿病%白内障%超声乳化术%黄斑变化
頻域OCT%糖尿病%白內障%超聲乳化術%黃斑變化
빈역OCT%당뇨병%백내장%초성유화술%황반변화
Spectral domain OCT%Diabetes%Cataract%Phacoemulsification%Macular changes
目的 应用频域OCT观察糖尿病患者在白内障超声乳化手术前、后黄斑中心凹厚度(CST)及黄斑容积(CV)的变化.方法 临床病例对照研究.对2012年1～12月在延边大学附属医院眼科选择单纯年龄相关性白内障患者31例31只眼作为Ⅰ组,糖尿病患者33例33只眼作为Ⅱ组,应用频域OCT检测两组在白内障术前及术后1天、1周、1、3个月的CST及CV进行对比比较;分析术后最佳矫正视力与CST的相关性及影响糖尿病患者黄斑结构改变的可能性因素.结果 两组比较CST增加术后1周,1个月差异有统计学意义(P ＜0.01,P＜0.01);CV增加术后1周,1个月,3个月差异有统计学意义(P ＜0.01,P＜0.01,P＜0.01).Ⅱ组在白内障术后1周,1个月,3个月最佳矫正视力与CST呈负相关(r=-0.179,r=-0.053,r=-0.034).Ⅱ组中,糖尿病病程10年以上者与10年以下者比较术后1个月,3个月CST增加,差异有统计学意义(P ＜0.01,P＜0.01);HbA1c≥6.5％者与HbA1c＜6.5％者比较术后1周,1个月CST增加,差异有统计学意义(P ＜0.05,P＜0.01).Ⅱ组术后出现2例黄斑水肿.结论 糖尿病是引起或加重黄斑水肿的重要原因之一.糖尿病病程长、糖化血红蛋白高是发生黄斑结构改变的高危因素.糖尿病患者在白内障超声乳化术后血-视网膜屏障的破坏是暂时、可逆的.
目的 應用頻域OCT觀察糖尿病患者在白內障超聲乳化手術前、後黃斑中心凹厚度(CST)及黃斑容積(CV)的變化.方法 臨床病例對照研究.對2012年1～12月在延邊大學附屬醫院眼科選擇單純年齡相關性白內障患者31例31隻眼作為Ⅰ組,糖尿病患者33例33隻眼作為Ⅱ組,應用頻域OCT檢測兩組在白內障術前及術後1天、1週、1、3箇月的CST及CV進行對比比較;分析術後最佳矯正視力與CST的相關性及影響糖尿病患者黃斑結構改變的可能性因素.結果 兩組比較CST增加術後1週,1箇月差異有統計學意義(P ＜0.01,P＜0.01);CV增加術後1週,1箇月,3箇月差異有統計學意義(P ＜0.01,P＜0.01,P＜0.01).Ⅱ組在白內障術後1週,1箇月,3箇月最佳矯正視力與CST呈負相關(r=-0.179,r=-0.053,r=-0.034).Ⅱ組中,糖尿病病程10年以上者與10年以下者比較術後1箇月,3箇月CST增加,差異有統計學意義(P ＜0.01,P＜0.01);HbA1c≥6.5％者與HbA1c＜6.5％者比較術後1週,1箇月CST增加,差異有統計學意義(P ＜0.05,P＜0.01).Ⅱ組術後齣現2例黃斑水腫.結論 糖尿病是引起或加重黃斑水腫的重要原因之一.糖尿病病程長、糖化血紅蛋白高是髮生黃斑結構改變的高危因素.糖尿病患者在白內障超聲乳化術後血-視網膜屏障的破壞是暫時、可逆的.
목적 응용빈역OCT관찰당뇨병환자재백내장초성유화수술전、후황반중심요후도(CST)급황반용적(CV)적변화.방법 림상병례대조연구.대2012년1～12월재연변대학부속의원안과선택단순년령상관성백내장환자31례31지안작위Ⅰ조,당뇨병환자33례33지안작위Ⅱ조,응용빈역OCT검측량조재백내장술전급술후1천、1주、1、3개월적CST급CV진행대비비교;분석술후최가교정시력여CST적상관성급영향당뇨병환자황반결구개변적가능성인소.결과 량조비교CST증가술후1주,1개월차이유통계학의의(P ＜0.01,P＜0.01);CV증가술후1주,1개월,3개월차이유통계학의의(P ＜0.01,P＜0.01,P＜0.01).Ⅱ조재백내장술후1주,1개월,3개월최가교정시력여CST정부상관(r=-0.179,r=-0.053,r=-0.034).Ⅱ조중,당뇨병병정10년이상자여10년이하자비교술후1개월,3개월CST증가,차이유통계학의의(P ＜0.01,P＜0.01);HbA1c≥6.5％자여HbA1c＜6.5％자비교술후1주,1개월CST증가,차이유통계학의의(P ＜0.05,P＜0.01).Ⅱ조술후출현2례황반수종.결론 당뇨병시인기혹가중황반수종적중요원인지일.당뇨병병정장、당화혈홍단백고시발생황반결구개변적고위인소.당뇨병환자재백내장초성유화술후혈-시망막병장적파배시잠시、가역적.
Objective To observe the changes of macular foveal thickness and macular volume on diabetic patients before and after cataract phacoemulsification combined with IOL implantation by spectral-domain optical coherence tomography (OCT).Methods Group Ⅰ:31 patients (31 eyes) with simple age-related cataract;group Ⅱ:33 patients (33 eyes) of with diabetes.Patients underwent phacoemulsification combined with IOL implantation.The changes of macular foveal thickness and macular volume of each group were measured by spectral-domain OCT before surgery and at 1 day,1 week,1 month and 3 months postoperative visits,respectively.Assess the relationship between postoperative best-corrected visual acuity (BCVA) and macular foveal thickness,and investigated correlating risk factors induced macular changes in diabetic patients.Results Macular foveal thickness was significantly different postoperatively between group Ⅰ and group Ⅱ at 1-and 4 weeks (P ＜ 0.01,P ＜0.01).Macular volume was increased significantly after surgery at 1,4,and 12 weeks (P ＜0.01,P ＜0.01,P ＜0.01).In the postoperative 1 week,1 month,and 3 months of group Ⅱ after cataract phacoemulsification,the correlation coefficient of the BCVA and foveal thickness was (r =-0.179,r =-0.053,r =-0.034) showing negative correlation.In group Ⅱ,macular foveal thickness of diabetes duration for more than 10 years were increased in postoperative 1 month and 3 months than that of 10 years below (P ＜0.01,P ＜0.01).HbAlc≥6.5％ were increased in postoperative 1 week and 1 month than HbAlc＜6.5％ (P ＜0.05,P ＜0.01).The spectral-domain OCT morphological analysis of group Ⅱ after phacoemulsification,2 cases appeared macular edema.Conclusions Diabetes is one of the most important risk factors to cause macular edema or become worse which is related to high glycosylated hemoglobin.The damage of blood-retinal barrier is temporary and reversible for diabetic patients after cataract phacoemulsification.
