眼轴长度与糖尿病性视网膜病变及其黄斑水肿相关研究  

Relationship between the axial length and risks of diabetic retinopathy and edema of the macular

作　　者：杨凯博[1] 胡悦东[1] 刘磊[1] 吴京阳[1] 张劲松[1] 卢迪[1] 陈蕾[1] 

机构地区：[1]中国医科大学附属第一医院眼科,沈阳110001

出　　处：《中国实用眼科杂志》2015年第5期517-522,共6页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究眼轴长度与糖尿病性视网膜病变（diabeticretinopathy，DR）及糖尿病性黄斑水肿（diabeticmacularedema，DME）的相关性。方法临床病例系列研究。收集2013年10月至2014年10月于中国医科大学附属第一医院糖尿病眼病防治中心就诊的2型糖尿病患者327例，应用A型超声测量眼轴长度，自动电脑验光仪测量屈光度，散瞳眼底照相进行DR和DME的分级：无DR、轻度NPDR、中度NPDR、重度NPDR和PDR，以及无DME、轻度DME、中度DME和重度DME，光学相干断层扫描（opticalcoherencetomography，OCT）确诊糖尿病性黄斑水肿。结果经过多元回归分析后，眼轴越长越不容易患重度NPDR，差异有统计学意义（OR，0．50；95％CI，0．37～0．98；P=0．04）和PDR（OR，0．63；95％CI，0．26～0．98；P=0．04）。眼轴越长更不容易患轻度DME，差异有统计学意义（OR，0．61；95％CI，0．37～0．97；P=O．02），中度DME（OR，0．61；95％CI，0．37～0．99；P=0．03）和重度DME（OR，0．50；95％CI，0．37～0．96；P=0．03）。结论眼轴长度与DR和DME之间存在相关性，长眼轴是重度DR和DME的保护性因素。Objective To evaluate the association of axial length with diabetic retinopathy （DR） and diabetic macular edema （DME） in persons with type-2 diabetes. Methods A total of 327 partic- ipants suffering from type-2 diabetes were chosen in Liaoning Diabetes Eye Center from October 2013 to October 2014, axial length was measured by A-scan ultrasound, refractive error was mea- sured using automatic refractometry, the severity of DR was graded into non-DR, mild NPDR, mod- erate NPDR, severe NPDR and PDR and DME, severity was classified as no DME, mild DME, moderate DME and severe DME according mydriatic fundus photographs, DME was confirmed by optical coherence tomography. Results In multivariate regression models, eyes with longer axial length were less likely to have severe NPDR （OR, 0.50; 95%CI, 0.37-0.98; P =0.04） and PDR （OR, 0.63; 95%CI, 0.26-0.98; P =0.04） and had a lower risk of mild DME （OR, 0.61; 95%CI, 0.37-0.97; P =0.02）, moderate DME （OR, 0.61; 95%CI, 0.37-0.99; P =0.03） and severe DME （OR, 0.50; 95% CI, 0.37-0.96, P =0.03）. Conclusions Axial length is associated with the presence and severity of DR and DME. Longer axial length is protective of severe DR and any DME.

关 键 词：糖尿病性视网膜病变 糖尿病性黄斑水肿 眼轴长度 屈光不正 

分 类 号：R587.2[医药卫生—内分泌]