Relationship between macular microcirculation and progression of diabetic macular edema
Relationship between macular microcirculation and progression of diabetic macular edema
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DOI：
10.1016/j.ophtha.2006.04.023
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发表时间：
2006-08-01
期刊：
影响因子：
13.7
通讯作者：
Hori, Sadao
中科院分区：
文献类型：
--
作者：
Sakata, Kumi;Funatsu, Hideharu;Hori, Sadao
目的：目的：探讨糖尿病黄斑水肿患者中心凹周围毛细血管血流速度与中心凹视网膜厚度的关系，以阐明糖尿病黄斑水肿的发病机制。参与者包括患有临床显著黄斑水肿的糖尿病患者（n = 22），方法：采用激光扫描检眼镜，荧光血管造影技术，对22例无黄斑水肿的糖尿病患者和16例健康志愿者的黄斑中心凹周围毛细血管血流速度进行检测，并进行追踪分析。无临床显著黄斑水肿的糖尿病患者的中心凹周围毛细血管异常的严重程度通过使用荧光素血管造影片，根据中心凹无血管区的大小和轮廓以及基线时中心凹毛细血管损失的程度进行分类。采用光学相干断层扫描仪测量中心凹视网膜厚度。主要指标：中心凹周围毛细血管血流速度与中心凹视网膜厚度的关系。黄斑水肿患者中心凹周围毛细血管血流速度明显减慢（0.94 +/- 0.09 mm/秒）与无临床显著黄斑水肿的患者相比（1.22 +/- 0.20 mm/秒）和健康志愿者（1.49 +/- 0.11 mm/秒; P < 0.0001）。毛细血管血流速度与中央凹视网膜厚度呈负相关（r =-0.4018，P < 0.0001）。无黄斑水肿的糖尿病患者的毛细血管血流速度不同，毛细血管血流速度与黄斑中心凹无血管区大小呈显著负相关（r =-0.52，P = 0.01），中心凹无血管区轮廓结论：糖尿病患者中心凹周围毛细血管血流速度的降低可能先于中心凹视网膜厚度的增加。长期血流速度降低可能增加黄斑区视网膜厚度，在糖尿病性黄斑水肿的发生和发展中起重要作用。(c)2006年，美国眼科学会。
Purpose: To investigate the relationship between blood flow velocity in perifoveal capillaries and retinal thickness at the central fovea in diabetic patients with clinically significant macular edema to elucidate the pathogenesis of diabetic macular edema.Design: Comparative, cross-sectional, prospective study.Participants: Participants included diabetic patients with clinically significant macular edema (n = 22), matched diabetic patients without clinically significant macular edema (n = 22), and healthy volunteers (n = 16).Methods: Perifoveal capillary blood flow velocity was measured with fluorescein angiography using a scanning laser ophthalmoscope and was analyzed by the tracing method. The severity of perifoveal capillary abnormalities among diabetic patients without clinically significant macular edema was classified by the size and outline of the foveal avascular zone and extent of foveal capillary loss at the baseline by the use of fluorescein angiograms. Retinal thickness at the central fovea was measured by optical coherence tomography.Main Outcome Measures: Relationship between perifoveal capillary blood flow velocity and retinal thickness at the central fovea.Results: Perifoveal capillary blood flow velocity was significantly slower in the patients with clinically significant macular edema (0.94 +/- 0.09 mm/second) compared with the patients without clinically significant macular edema (1.22 +/- 0.20 mm/second) and the healthy volunteers (1.49 +/- 0.11 mm/second; P < 0.0001). Capillary blood flow velocity negatively correlated with retinal thickness at the central fovea (r = -0.4018, P < 0.0001). Capillary blood flow velocity varied among diabetic patients without clinically significant macular edema, and there were significant negative correlations between capillary blood flow velocity and the size of the foveal avascular zone (r = -0.52, P = 0.01), the outline of the foveal avascular zone (r = -0.44, P = 0.04), and the extent of foveal capillary loss (r = -0.51, P = 0.01).Conclusions: The reduction of perifoveal capillary blood flow velocity may occur before the increase of retinal thickness at the central fovea in the diabetic patients. It is possible that long-term reduction of blood flow velocity increases retinal thickness of the macula and may play an important role in the development and the progression of diabetic macular edema. (c) 2006 by the American Academy of Ophthalmology.