Selective loss of inner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy.
Selective loss of inner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy.
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DOI：
10.1167/iovs.08-3143
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发表时间：
2009-07
影响因子：
4.4
通讯作者：
Abràmoff MD
中科院分区：
文献类型：
--
作者：
van Dijk HW;Kok PH;Garvin M;Sonka M;Devries JH;Michels RP;van Velthoven ME;Schlingemann RO;Verbraak FD;Abràmoff MD
通过比较无糖尿病视网膜病变或轻度糖尿病视网膜病变（DR）的1型糖尿病患者与年龄和性别匹配的健康对照者的6层视网膜厚度，确定1型糖尿病是否优先影响视网膜内层。57例无DR （n = 32）或轻度DR （n = 25）的1型糖尿病患者接受了全面眼科检查、立体眼底摄影和光学相干断层扫描（OCT）。在自动分割OCT图像的视网膜层后，计算中央凹、中央周区和中央黄斑周围区的六层视网膜的平均厚度，并与年龄和性别匹配的对照组进行比较。在轻度DR患者中，与年龄匹配的对照组相比，中央黄斑中央周围区域的神经节细胞/内丛状层平均薄2.7 μm(95%可信区间[CI]， 2.1 - 4.3 μm)，平均内核层薄1.1 μm （95% CI, 0.1-2.1 μm）。外周区神经节细胞/内丛状层的平均厚度明显变薄。其他各层均无显著差异。与健康对照相比，伴有轻度视网膜病变的1型糖尿病患者的全视网膜变薄是由于视网膜内层的选择性变薄，这支持了早期DR包括神经退行性成分的概念。
To determine whether type 1 diabetes preferentially affects the inner retinal layers by comparing the thickness of six retinal layers in type 1 diabetic patients who have no or minimal diabetic retinopathy (DR) with those of age- and sex-matched healthy controls. Fifty-seven patients with type 1 diabetes with no (n = 32) or minimal (n = 25) DR underwent full ophthalmic examination, stereoscopic fundus photography, and optical coherence tomography (OCT). After automated segmentation of intraretinal layers of the OCT images, mean thickness was calculated for six layers of the retina in the fovea, the pericentral area, and the peripheral area of the central macula and were compared with those of an age- and sex-matched control group. In patients with minimal DR, the mean ganglion cell/ inner plexiform layer was 2.7 μm thinner (95% confidence interval [CI], 2.1– 4.3 μm) and the mean inner nuclear layer was 1.1 μm thinner (95% CI, 0.1–2.1 μm) in the pericentral area of the central macula compared to those of age-matched controls. In the peripheral area, the mean ganglion cell/inner plexiform layer remained significantly thinner. No other layers showed a significant difference. Thinning of the total retina in type 1 diabetic patients with minimal retinopathy compared with healthy controls is attributed to a selective thinning of inner retinal layers and supports the concept that early DR includes a neurode-generative component.
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