Assessment of the Tear Meniscus Using Optical Coherence Tomography in Patients With Type 2 Diabetes Mellitus
Assessment of the Tear Meniscus Using Optical Coherence Tomography in Patients With Type 2 Diabetes Mellitus
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DOI：
10.1097/ico.0000000000000651
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发表时间：
2015-12-01
期刊：
影响因子：
2.8
通讯作者：
Chung, Sung Kun
中科院分区：
文献类型：
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作者：
Baek, Jiwon;Doh, Sang Hee;Chung, Sung Kun
目的：方法：采用傅立叶域光学相干断层扫描（FD-OCT）技术，对54例2型糖尿病无视网膜病变（DR）、45例非增殖性DR、25例增殖性DR患者及45例正常对照者进行分析。对DR的血红蛋白A1 c和早期治疗糖尿病视网膜病变研究（ETDRS）分期进行了评价。进行泪液分泌试验（ST）、泪膜破裂时间试验和荧光素角膜染色。通过FD-OCT获得撕裂半月板高度（TMH）、撕裂半月板深度（TMD）和撕裂半月板面积（TMA）。糖尿病组和对照组的TMH、TMD和TMA分别为233 ± 79 μ m、148 ± 53 μ m和0.026 ± 0.015 mm（2），261 ± 67 μ m、167 ± 49 μ m，和0.032 +/- 0.017 mm（2）。糖尿病组各项指标均低于正常对照组（P均< 0.01）。PDR中的值分别为185 ± 90 μ m、117 ± 50 μ m和0.017 ± 0.010 mm（2），低于对照组和非增殖性DR中的值（227 ± 71 μ m、144 ± 50 μ m和0.023 ± 0.010 mm（2））（均P < 0.01）。TMH、TMD和TMA与ST（分别为P < 0.01、P = 0.02和P < 0.01）和角膜染色评分（均P < 0.01）相关。结论：OCT结合泪膜破裂时间和ST段沿着变化是评价2型糖尿病患者泪液功能的有效方法。PDR患者和全视网膜光凝的历史显示较低的泪半月板参数。泪液半月板参数的降低与糖尿病病程相关。
Purpose: To analyze tear meniscus dimensions with Fourier domain-optical coherence tomography (FD-OCT) in patients with type 2 diabetes mellitus.Methods: Patients with type 2 diabetes without diabetic retinopathy (DR) (n = 54), with nonproliferative DR (n = 45), with proliferative DR (PDR) (n = 25), and controls (n = 45) were enrolled. Hemoglobin A1c and Early Treatment Diabetic Retinopathy Study (ETDRS) stages of DR were evaluated. Schirmer test (ST), tear breakup time test, and fluorescein corneal staining were carried out. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus area (TMA) were obtained by FD-OCT.Results: TMH, TMD, and TMA in the diabetes and control groups were 233 79 mu m, 148 +/- 53 mu m, and 0.026 +/- 0.015 mm(2), and 261 +/- 67 mu m, 167 +/- 49 mu m, and 0.032 +/- 0.017 mm(2), respectively. All parameters were lower in diabetes (all P < 0.01). And the values in PDR were 185 +/- 90 mu m, 117 +/- 50 mu m, and 0.017 +/- 0.010 mm(2) which were lower than those in control and nonproliferative DR (227 +/- 71 mu m, 144 +/- 50 mu m, and 0.023 +/- 0.010 mm(2)) (all P < 0.01). TMH, TMD, and TMA correlated with ST (P < 0.01, P = 0.02, and P < 0.01, respectively) and the corneal staining score (all P < 0.01). Patients with longer diabetes duration and a history of panretinal photocoagulation showed significantly decreased TMH, TMD, and TMA (P < 0.01).Conclusions: OCT, along with tear breakup time and ST, is an effective way to assess tear function in type 2 diabetes. Patients with PDR and a history of panretinal photocoagulation showed lower tear meniscus parameters. The decrease in tear meniscus parameters was correlated with diabetes duration.