Diabetik retinopatisi olmayan tip 1 ve tip 2 diabetes mellituslu hastalarda optik koherens tomografi ile maküler kalınlık ve retina sinir lifi tabakası ölçümleri
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Tarih
2010
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info:eu-repo/semantics/openAccess
Özet
Amaç: Diabetik Retinopatisi olmayan tip 1 ve tip 2 diabetes mellituslu hastalarda optik koherens tomografi ile makuler kalınlık ve retina sinir lifi tabakası kalınlığını değerlendirmek ve bu değerleri kontrol grubunda elde edilen değerler ile karşılaştırmak. Gereç ve Yöntem: Çalışmaya diabetik retinopatisi olmayan 50 adet tip 1 ve 50 adet tip 2 diabetes mellituslu hasta ile diabetes mellitusu olmayan 50 gönüllü dahil edilmiştir. Tüm hastaların ve gönüllülerin her bir gözünde en iyi düzeltilmiş görme keskinliği belirlenerek, ayrıntılı ön ve arka segment muayeneleri yapılmış ve göz içi basınçları kaydedilmiştir. Tüm hastaların ve gönüllülerin her bir gözüne optik koherens tomografi ile hızlı makuler kalınlık “fast macular thickness” ve makuler kalınlık taramaları yapıldı. “Retinal thickness/volume” protokolü ile santral 1 mm alandaki retinal kalınlık ve total makuler volüm otomatik olarak ölçülmüştür. Gruplar arasındaki karşılaştırma santral 1 mm alandaki horizontal tarama değerlerine ve total makuler volüm değerlerine göre yapılmıştır. Retina sinir lifi tabakası ölçümünde Retinal Nerve Fiber Layer “Thickness Average” metodu kullanılarak 25 adet tip 1, 25 adet tip 2 diabetes mellituslu hasta ile 25 gönüllünün 50’şer gözünde retina sinir lifi tabakası kalınlığı temporal, nazal, superior ve inferior kadranlarda ölçülmüştür. Bulgular: Santral 1 mm’lik alandaki retinal kalınlık, tip 1 diabetes mellitus grubunda 186.02±30.14 ? (112-272), tip 2 diabetes mellitus grubunda 195.92±25,44 ? (118-274) iken, kontrol grubunda 195.92±28.82 ? (136-295) idi. Gruplar arasında karşılaştırma yapıldığında, tip 1 diabetes mellitus grubunda retinal kalınlık ortalaması diğer 2 gruba göre istatistiksel olarak anlamlı derecede düşük bulundu (p=0.017). Total makuler volüm değerleri ise, tip 1 diabetes mellitus grubunda 6.81±0.58 mm³ (3.5-7.9), tip 2 diabetes mellitus grubunda 6.86±0.51mm³ (4.9-9.2), kontrol grubunda 7.03±0.65 mm³ (5-10) idi. Gruplar arasında karşılaştırma yapıldığında, tip 1diabetes mellitus grubundaki total makuler volüm değerlerinin kontrol grubuna ve tip 2 diabetes mellitus grubuna göre daha düşük olduğu ve sadece tip 1 diabetes mellitus grubu ile kontrol grubu arasındaki farkın istatistiksel olarak anlamlı olduğu saptanmıştır (p=0.023). Retina sinir lifi tabaksı kalınlığı ise nazal kadranda tip 1 diabetes mellitus grubunda 77.72±14.43 ?m (48-125), tip 2 diabetes mellitus grubunda 68.08±15.72 ?m (42-108) iken, kontrol grubunda 73.74±25.25 ?m (38-194) idi. Gruplar arası karşılaştırma yapıldığında tip 1 ile tip 2 diabetes mellitus arasındaki fark istatistiksel olarak anlamlı bulundu (p=0.043). Sonuç: Diabetik retinopatisi olmayan tip 1 diabetes mellituslu grupta horizontal kadranda retinal kalınlık değeri, kontrol grubu ve tip 2 diabetes mellituslu gruba göre daha düşük saptanmış, gruplar arası karşılaştırma yapıldığında tip 1 diabetes mellituslu grupta retinal kalınlık değeri her iki gruba göre istatistisel olarak anlamlı derecede düşük bulunmuştur. Gruplar arasında total makuler volüm açısından karşılaştırma yapıldığında ise; tip 1 diabetes mellituslu hasta grubu ile kontrol grubu arasındaki fark istatistiksel olarak anlamlı bulunmuştur. Diabetik retinopatisi olmayan tip 2 diabetes mellituslu hastalarda ise tüm kadranlarda ve ortalama retina sinir lifi tabakasında kontrol grubuna göre incelme olduğu, gruplar arası karşılaştırma yapıldığında, bu incelmenin sadece nazal kadranda tip 1 diabetes mellituslu hastalar ile tip 2 diabetes mellituslu hastalar arasında istatistiksel olarak anlamlı derecede düşük olduğu bulunmuştur.
Purpose: To evaluate macular thickness and retinal nerve fiber thickness measurements with optic coherence tomography in type 1 and type 2 diabetes mellitus patients without retinopathy and to compare these results with those of a normal group. Materials and Methods: In patients with 50 type 1 and 50 type 2 diabetes mellitus without retinopathy and 50 volunteers without diabetes mellitus were enrolled in this study. Best corrected visual acuity of all patients and all volunteers was determined and detailed anterior and posterior segment examinations were performed. Intraocular pressures were evaluated using a Goldman aplanation tonometer. Each eye of the patients and normal group was scanned with optic coherence tomography using fast macular thickness and macular thickness protocols. Retinal thickness and total macular volume were calculated automatically in the central 1 mm area using the retinal thickness/volume protocol. The groups were compared to each other according to horizontal scans of the central 1 mm area and total macular volume measurements. Retinal nerve fiber layer thickness measurements of 50 eyes of each 25 type 1 and 25 type 2 diabetes mellitus patients and 25 volunteers were done using the retinal nerve fiber layer ‘thickness average’ method and evaluated in superior, temporal, nasal, and inferior areas. Results: Retinal thickness was 186.02±30.138 μ (112-272) in type 1 diabetes mellitus patients, 195.92±25.44 μ (118-274) in type 2 diabetes mellitus patients, and 195.92±28.82 μ (136-295) in the normal group in the central 1 mm area. Retinal thickness average was significantly lower in type 1 diabetes mellitus patients than in the other 2 groups (p=0.017). Total macular volume was 6.81±0.58 mm³ (3.5-7.9) in type 1 diabetes mellitus patients, 6.86±0.51 mm³ (4.9-9.2) in type 2 diabetes mellitus patients, and 7.03±0.65 mm³ (5-10) in the normal group. Total macular volume in type 1 diabetes mellitus patients was lower than in type 2 diabetes mellitus patients and the control group, and the difference between type 1 diabetes mellitus patients and the control group was significant (p=0.023). Retinal nerve fiber layer thickness was 77.72±14.43 μm (48-125) in type 1 diabetes mellitus patients, 68.08±15.72 μm (42-108) in type 2 diabetes mellitus patients, and 73.74±25.25 μm (38-194) in the control group in the nasal area. The difference between type 1 diabetes mellitus patients and type 2 diabetes mellitus patients in the nasal area was significant (p=0.043). Conclusion: Retinal thickness measurements in the horizontal area were significantly lower in type 1 diabetes mellitus patients without retinopathy than in type 2 diabetes mellitus patients without retinopathy and the control group. Total macular volume difference between type 2 diabetes mellitus patients and the control group was significant. Retinal nerve fiber layer thickness was less than the other 2 groups in all areas and in average values in type 2 diabetes mellitus patients, but only the values in the nasal area were significantly lower between type 2 and type 1 diabetes mellitus patients.
Purpose: To evaluate macular thickness and retinal nerve fiber thickness measurements with optic coherence tomography in type 1 and type 2 diabetes mellitus patients without retinopathy and to compare these results with those of a normal group. Materials and Methods: In patients with 50 type 1 and 50 type 2 diabetes mellitus without retinopathy and 50 volunteers without diabetes mellitus were enrolled in this study. Best corrected visual acuity of all patients and all volunteers was determined and detailed anterior and posterior segment examinations were performed. Intraocular pressures were evaluated using a Goldman aplanation tonometer. Each eye of the patients and normal group was scanned with optic coherence tomography using fast macular thickness and macular thickness protocols. Retinal thickness and total macular volume were calculated automatically in the central 1 mm area using the retinal thickness/volume protocol. The groups were compared to each other according to horizontal scans of the central 1 mm area and total macular volume measurements. Retinal nerve fiber layer thickness measurements of 50 eyes of each 25 type 1 and 25 type 2 diabetes mellitus patients and 25 volunteers were done using the retinal nerve fiber layer ‘thickness average’ method and evaluated in superior, temporal, nasal, and inferior areas. Results: Retinal thickness was 186.02±30.138 μ (112-272) in type 1 diabetes mellitus patients, 195.92±25.44 μ (118-274) in type 2 diabetes mellitus patients, and 195.92±28.82 μ (136-295) in the normal group in the central 1 mm area. Retinal thickness average was significantly lower in type 1 diabetes mellitus patients than in the other 2 groups (p=0.017). Total macular volume was 6.81±0.58 mm³ (3.5-7.9) in type 1 diabetes mellitus patients, 6.86±0.51 mm³ (4.9-9.2) in type 2 diabetes mellitus patients, and 7.03±0.65 mm³ (5-10) in the normal group. Total macular volume in type 1 diabetes mellitus patients was lower than in type 2 diabetes mellitus patients and the control group, and the difference between type 1 diabetes mellitus patients and the control group was significant (p=0.023). Retinal nerve fiber layer thickness was 77.72±14.43 μm (48-125) in type 1 diabetes mellitus patients, 68.08±15.72 μm (42-108) in type 2 diabetes mellitus patients, and 73.74±25.25 μm (38-194) in the control group in the nasal area. The difference between type 1 diabetes mellitus patients and type 2 diabetes mellitus patients in the nasal area was significant (p=0.043). Conclusion: Retinal thickness measurements in the horizontal area were significantly lower in type 1 diabetes mellitus patients without retinopathy than in type 2 diabetes mellitus patients without retinopathy and the control group. Total macular volume difference between type 2 diabetes mellitus patients and the control group was significant. Retinal nerve fiber layer thickness was less than the other 2 groups in all areas and in average values in type 2 diabetes mellitus patients, but only the values in the nasal area were significantly lower between type 2 and type 1 diabetes mellitus patients.
Açıklama
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Retina-Vitreus
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Cilt
18
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4
