| 摘要: |
| 目的 研究糖尿病视网膜病变（DR）早期患者Bruch膜开口-盘沿最小宽度（BMO-MRW）的变化。方法 采用观察性横断面研究方法。选取2020年3月至12月于我院就诊的2型糖尿病患者123例（208眼）及同期健康志愿者66名（121眼）作为研究对象，依据国际临床DR严重程度分级标准，将2型糖尿病患者分为无DR组（non-DR组，n＝72）和轻度DR组（mild-DR组，n＝51）。应用频域光学相干断层成像（SD-OCT）进行以视盘为中心的24条放射状B扫描及视乳头周围环形扫描，所有扫描结果均相对于该眼特定的黄斑-Bruch膜开口中心轴（FoBMO轴）获得。测量24条B扫描径线上的BMO-MRW值及环形扫描的视网膜神经纤维层（RNFL）厚度值，并进一步分为鼻上、鼻侧、鼻下、颞上、颞侧、颞下6个象限进行统计分析。结果 正常对照组、non-DR组、mild-DR组平均BMO-MRW及各象限BMO-MRW均呈依次变薄趋势。non-DR组、mild-DR组的平均BMO-MRW分别为（304.64±36.67）μm、（299.39±41.27）μm，相较于正常对照组［（315.14±41.60）μm］变薄（P＝0.040，P＝0.005）。non-DR组、mild-DR组颞上象限BMO-MRW分别为（308.35±52.40）μm、（304.60±53.33）μm，相较于正常对照组［（324.82±52.40）μm］变薄（P＝0.012，P＝0.005）；颞下象限BMO-MRW分别为（339.49±51.39）μm、（331.48±47.21）μm，相较于正常对照组［（358.58±48.94）μm］变薄（P＝0.003，P<0.001）。平均BMO-MRW和平均RNFL厚度呈正相关（r＝0.187，P＝0.001），各象限BMO-MRW与RNFL厚度呈中等相关至无相关性，其中颞下象限相关性最高（r＝0.333，P<0.001），颞侧象限无相关性（r＝0.087，P＝0.115）。结论 糖尿病患者的BMO-MRW较正常人变薄，且与RNFL厚度改变呈正相关，提示BMO-MRW可以作为DR早期神经退行性改变的观察指标。 |
| 关键词: 糖尿病视网膜病变 光学相干断层成像 Bruch膜开口-盘沿最小宽度 视网膜神经纤维层厚度 |
| DOI：10.16781/j.CN31-2187/R.20210122 |
| 投稿时间：2021-02-05修订日期：2021-05-08 |
| 基金项目: |
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| Change of Bruch's membrane opening-minimum rim width in early diabetic retinopathy |
| ZHOU Jun△,LOU Wei△,WANG Xiang-ning,WU Qiang* |
(Department of Ophthalmology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To study the change of Bruch's membrane opening-minimum rim width (BMO-MRW) inpatients with early diabetic retinopathy (DR). Methods This was an observational cross-sectional study. A total of 123 patients (208 eyes) with type 2 diabetes mellitus and 66 (121 eyes) healthy volunteers (normal control group) in our hospital from Mar. to Dec. 2020 were enrolled. According to the international clinical DR severity grading scale, type 2 diabetes mellitus patients were divided into non-DR group (n=72) and mild-DR group (n=51). Spectral-domain optical coherence tomography (SD-OCT) was used to perform 24 radial B-scan centered on the optic disc and peripapillary circular scan. All scanning results were obtained relative to the specific axis of the fovea-BMO center (FoBMO axis) of the eye. The values of BMO-MRW and circular retinal nerve fiber layer (RNFL) thickness on 24 B-scan lines were measured, and the data were analyzed in 6 sectors (superonasal, nasal, inferonasal, superotemporal, temporal, and inferotemporal) for statistical analysis. Results The mean BMO-MRW values and each sector BMO-MRW values of the normal control group, non-DR group and mild-DR group showed a decreasing trend. The mean BMO-MRW values of the non-DR group and mild-DR group were (304.64±36.67) μm and (299.39±41.27) μm, which were significantly thinner than that of the normal control group ([315.14±41.60] μm) (P=0.040 and 0.005, respectively). The BMO-MRW values in the superotemporal sector of the non-DR group and mild-DR group were (308.35±52.40) μm and (304.60±53.33) μm, which were significantly thinner than that of the normal control group ([324.82±52.40] μm) (P=0.012 and 0.005, respectively). The BMO-MRW values in the inferotemporal sector of the non-DR group and mild-DR group were (339.49±51.39) μm and (331.48±47.21) μm, which were also significantly thinner than that of the normal control group ([358.58±48.94] μm) (P=0.003 and P<0.001, respectively). The mean BMO-MRW was significantly positively correlated with the mean RNFL thickness (r=0.187, P<0.001). The correlation between BMO-MRW and RNFL thickness in each sector ranged from medium correlation (with the highest correlation in inferotemporal sector; r=0.333, P<0.001) to no correlation (in temporal sector; r=0.087, P=0.115). Conclusion The BMO-MRW of diabetic patients is thinner than that of normal controls, and it is positively correlated with the changes of RNFL thickness, suggesting that BMO-MRW can be used as an indicator of early neurodegenerative changes in DR. |
| Key words: diabetic retinopathy optical coherence tomography Bruch's membrane opening-minimum rim width retinal nerve fiber layer thickness |
