Association between the short-term natural history of diabetic macular edema and the vitreomacular relationship in type II diabetes mellitus
Association between the short-term natural history of diabetic macular edema and the vitreomacular relationship in type II diabetes mellitus
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DOI：
10.1016/s0161-6420(97)30289-9
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发表时间：
1997-03-01
期刊：
影响因子：
13.7
通讯作者：
Yoshida, A
中科院分区：
文献类型：
--
作者：
Hikichi, T;Fujio, N;Yoshida, A
目的：作者确定了未经治疗的糖尿病性黄斑水肿和玻璃体黄斑relationships.Methods的短期自然史之间的关联：作者前瞻性研究了82例II型糖尿病患者的临床显着的黄斑水肿超过6个月的时间。他们使用多元线性回归分析来评估10个变量对诊断后6个月黄斑水肿的短期自然史的影响：年龄;性别;诊断黄斑水肿时的糖尿病病程;血红蛋白A1;胰岛素使用;蛋白尿的存在;全身性高血压、心脏疾病或两者的存在;糖尿病视网膜病变的程度;全视网膜光凝的病史;结果：在研究开始时，22只眼（27%）有玻璃体黄斑分离，60只眼（73%）没有。诊断后6个月，27只（33%）眼睛的黄斑水肿自发消退。在22只玻璃体黄斑分离的眼中，12只（55%）在6个月后黄斑水肿自发消退，而在60只玻璃体黄斑粘连的眼中，只有15只（25%）自发消退（P = 0.01）。逐步回归分析显示玻璃体黄斑分离（P = 0.01）和糖尿病病程（P = 0.03）有助于黄斑水肿的消退。在27只黄斑水肿消退的眼睛中，17只（63%）视力改善超过两行，而如果黄斑水肿持续存在，则没有眼睛视力改善。结果：玻璃体黄斑分离组视力提高2行以上的发生率（36%，8/22）显著高于无玻璃体黄斑分离组（15%，9/60; P = 0.04）。结论：玻璃体黄斑分离可促进糖尿病黄斑水肿的自然消退，从而提高视力。
Purpose: The authors ascertain the association between the short-term natural history of untreated diabetic macular edema and the vitreomacular relationship.Methods: The authors prospectively studied 82 type II diabetic patients with clinically significant macular edema over a six-month period. They used multiple linear regression analysis to evaluate the effect of ten variables on the short-term natural history of macular edema 6 months after diagnosis: age; gender; diabetes duration at diagnosis of macular edema; hemoglobin A1; insulin use; presence of proteinuria; presence of systemic hypertension, cardiac disorders, or both; degree of diabetic retinopathy; history of panretinal photocoagulation; and vitreomacular relationships, as determined by preset lens biomicroscopy.Results: At study entry, 22 (27%) eyes had vitreomacular separation and 60 (73%) eyes did not. Macular edema spontaneously resolved in 27 (33%) eyes 6 months after diagnosis. Of the 22 eyes with vitreomacular separation at study entry, 12 (55%) had spontaneous resolution of macular edema after 6 months, whereas only 15 of 60 (25%) of the eyes with vitreomacular adhesion at study entry had spontaneous resolution (P = 0.01). Stepwise regression analysis indicated that vitreomacular separation (P = 0.01) and diabetes duration (P = 0.03) contribute to resolution of macular edema. Of the 27 eyes with resolved macular edema, 17 (63%) had improved visual acuity of more than two lines, whereas no eyes had improved visual acuity if macular edema persisted. The prevalence of improved visual acuity of more than two lines was significantly higher in eyes with vitreomacular separation at study entry (36%, 8/22) than in eyes without (15%, 9/60; P = 0.04).Conclusion: Our findings suggest that vitreomacular separation may promote the spontaneous resolution of diabetic macular edema and consequently improve visual acuity.