Comparison of Optic Nerve Head Topographic Parameters in Patients With Primary Open-Angle Glaucoma With and Without Diabetes Mellitus
Comparison of Optic Nerve Head Topographic Parameters in Patients With Primary Open-Angle Glaucoma With and Without Diabetes Mellitus
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DOI：
10.1097/ijg.0000000000000096
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发表时间：
2016-01-01
影响因子：
2
通讯作者：
Ozturk, Faruk
中科院分区：
文献类型：
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作者：
Akkaya, Serkan;Can, Ertugrul;Ozturk, Faruk
目的：为评价原发性开角型青光眼（primary open-angle glaucoma，POAG）患者的视神经乳头（optic nerve head，ONH）参数，并探讨糖尿病代谢控制对ONH地形图的影响，材料与方法：选择原发性开角型青光眼（primary open-angle glaucoma，POAG）合并2型糖尿病患者60例（60只眼），非糖尿病患者41例（41只眼）作为对照组。所有患者均进行了完整的眼科检查，并采用海德堡视网膜断层扫描（HRT）III对定量视盘参数进行了评估。糖尿病患者的HbA 1c测量进行了评估，在同一天，当眼科assessments.Results：平均边缘面积和边缘体积的研究组是统计学高于对照组（P = 0.04边缘面积和P = 0.02边缘体积）。HRT其他参数组间差异无显著性（P > 0.05）。在研究组中，糖尿病病程与边缘面积和边缘体积无显著相关性（边缘面积r = 0.03，P = 0.81;边缘体积r = 0.03，P = 0.79）。协方差分析显示，年龄、性别、MD和PSD值对边缘面积和边缘体积的影响不显著（P > 0.05）。HbA 1c水平与一些HRT参数（包括椎间盘面积、杯面积、杯体积和杯形状测量）之间存在微弱但具有统计学意义的相关性（椎间盘面积r = 0.35和P = 0.006;髋臼杯面积r = 0.35和P = 0.006;髋臼杯体积r = 0.32和P = 0.01;髋臼杯形状测量r = 0.32和P = 0.01）。本研究结果提示糖尿病对原发性开角型青光眼视神经损害具有保护作用。然而，需要更大规模的对照研究来证实这些发现。
Purpose: To evaluate the optic nerve head (ONH) parameters of primary open-angle glaucoma (POAG) patients with and without diabetes and to investigate the effect of the metabolic control of diabetes on ONH topography.Materials and Methods: A study group of 60 eyes of 60 POAG patients with type 2 diabetes mellitus and a control group of 41 eyes of 41 POAG patients without diabetes were recruited for the study. Complete ophthalmic examinations of all patients were performed and the quantitative optic disc parameters were evaluated with Heidelberg retina tomography (HRT) III. HbA1c measurements of diabetic patients were assessed on the same day when the ophthalmic assessments were performed.Results: Mean rim area and rim volume of the study group was statistically higher than the control group (P = 0.04 for rim area and P = 0.02 for rim volume). The difference in other parameters of the HRT between the groups were insignificant (P > 0.05). In the study group, the duration of the diabetes was not significantly correlated to rim area and rim volume (r = 0.03, P = 0.81 for rim area; r = 0.03, P = 0.79 for rim volume). Analysis of covariance showed insignificant effects of age, sex, MD, and PSD values over rim area and rim volume (P > 0.05). There were weak but statistically significant correlations between HbA1c levels and some HRT parameters including disc area, cup area, cup volume, and cup shape measure (r = 0.35 and P = 0.006 for disc area; r = 0.35 and P = 0.006 for cup area; r = 0.32 and P = 0.01 for cup volume; r = 0.32 and P = 0.01 for cup shape measure).Conclusions: The results of this study imply the protective effect of diabetes over glaucomatous optic nerve damage in POAG patients. However, larger and controlled studies are warranted to confirm those findings.