Yeni Tanılı Diyabetes Mellitus Hastalarında Peripapiller Retina Sinir Lifi Tabakası
Ve Subfoveal Koroid Kalınlığının Spektralis OCT İle Değerlendirilmesi
Amaç: Bu çalışmada amacımız, yeni tanı alan ve herhangi bir diyabetik retinopati (DR) bulgusu olmayan tip 2 diyabetes mellituslu (DM) olgularla sağlıklı bireylerin peripapiller retina sinir lifi tabakası (pRSLT) ve koroid tabakası kalınlıklarını karşılaştırmaktır. Yöntemler: Çalışmaya Endokrin polikliniğinden yeni tanı almış ve DR’si olmayan DM’li hastalar ile sağlıklı kontrol grubu dahil edildi. Olguların Spectral-Domain optik koherens tomografi (spektralis OKT) cihazı ile EDI modunda (enhanced depth imaging- artırılmış derinlik görüntülemesi) horizontal düzlemde taraması yapıldı. Alınan görüntülerden fovea merkezinden, fovea merkezine 1000 μm temporal ve nazalden koroid kalınlıkları ölçümü yapıldı. Ayrıca aynı cihazla pRSLT kalınlık ölçümü yapıldı. Bulgular: Çalışmaya DR’si olmayan 28 yeni tanılı DM hastasının 28 gözü ile 28 kontrol grubunun 28 gözü dahil edildi. Yaş, cinsiyet, sferik ekivalan, düzeltilmiş en iyi görme keskinliği, göz içi basıncı ve aksiyel uzunluk değerlerinde gruplar arasında anlamlı farklılık saptanmadı. Subfoveal ve temporal alanda koroid kalınlığının yeni tanılı DM grubunda kontrol grubuna göre daha ince olduğu saptandı (sırasıyla p=0,04, p=0,006). pRNFL analizinde ise averaj, nazal ve temporal süperior kadranlar yeni tanılı DM grubunda kontrol grubuna göre anlamlı olarak daha ince bulundu. Diğer pRNFL kadranlarında anlamlı bir fark saptanmadı. Sonuç: Çalışmamızın verileri değerlendirildiğinde yeni tanılı DM’li hastalarda DR bulguları olmaksızın koroid tabakasında incelmenin yanında pRSLT’de bazı incelmelerin (özellikle averaj, nazal ve temporal süperior kadranlarda) olabileceğini söylemek mümkün görünmektedir
Evaluation Of The Peripapillary Retinal Nerve Fiber Layer And Subfoveal Choroidal Thickness In Naive Patients With Diabetes Mellitus With Spectralis OCT
Objective: We aimed to compare the peripapillary retinal nerve fiber layer (pRNFL) and choroidal thickness in naive type 2 diabetic patients without diabetic retinopathy (DR) with healthy subjects. Methods: The study included newly diagnosed diabetic patients without DR and healthy control subjects. Horizontal plane scan of choroid was performed using enhanced depth imaging (EDI) mode of spectral-domain optical coherence tomography (SD-OCT). The choroidal thickness was measured at the central fovea and at 1000 μm nasal and temporal from the center of the fovea. In addition, the same measurements were performed for pRNFL thickness. Results: The study included 28 eyes of the 28 newly diagnosed with diabetic patients without DR and 28 eyes of the 28 healthy subjects. Age, gender, spherical equivalent refraction, best-corrected visual acuity, intraocular pressure and axial length were not difference between groups. The choroidal thickness of subfoveal and temporal areas were thinner in the naive DM group than that of control group (p = 0.04, p = 0.006, respectively.). In pRNFL analysis, average, nasal and superior temporal quadrants were significantly thinner in the newly diagnosed with DM than those of control group. There were no significant differences in other pRNFL quadrants. Conclusion: When the data were analyzed, in addition to thinning of the choroid layer, it is possible to say that some thinning can be observed in the pRNFL particularly at the average, nasal and temporal superior quadrants in the patients newly diagnosed with DM without DR.
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