糖尿病性黄斑水肿患眼微视野计参数和BCVA与黄斑区形态的相关性

目的：探究糖尿病性黄斑水肿患者黄斑完整性评估(MAIA)微视野计参数及最佳矫正视力(BCVA)和黄斑区形态结构特征的相关性。

方法：选取2018-03/2020-01在我院眼科就诊的糖尿病性黄斑水肿患者43例74眼。检查患眼MAIA微视野计参数与黄斑区外界膜及内感光层和外感光层结联(IS/OS)层完整性。分析各区域视网膜厚度及视网膜敏感度的相关性，并分析IS/OS层完整组及缺损组视网膜厚度与视网膜敏感度、BCVA的相关性。

结果：与IS/OS层缺损组比较，IS/OS层完整组患者BCVA(LogMAR)、中心视网膜厚度(CRT)、由注视点组成的63%二元轮廓椭圆面积(BCEA63)、由注视点组成的95%二元轮廓椭圆面积(BCEA95)及黄斑完整性指数(MI)水平更低，视网膜敏感度的黄斑区平均阈值(AT)、2°固视率(P2)水平更高(均P<0.01)，但两组患者中心视网膜容积(CRV)、1°固视率(P1)水平无差异(均P>0.05)。与外界膜缺损组比较，外界膜完整组患者BCVA(LogMAR)、CRT、MI水平更低(均P<0.05)，但两组患者CRV、AT、P1、P2、BCEA63、BCEA95水平无差异(均P>0.05)。存在硬性渗出组和不存在硬性渗出组患者各眼部参数水平均无差异(P>0.05)。纳入患者视网膜厚度及视网膜敏感度在中心凹颞侧、中央及鼻侧处呈明显负相关(P<0.05)，而在中心凹上方、下方无明显相关性(P>0.05)。IS/OS层完整组患者AT与CRT、BCVA均呈负相关，而CRT与BCVA呈正相关(均P<0.05)； IS/OS层缺损组患者AT与BCVA呈负相关(P<0.05)

结论：糖尿病性黄斑水肿患眼MAIA微视野计参数与黄斑区形态结构密切相关，尤其是IS/OS层及外界膜的完整性，其可能是评价患者患眼黄斑区视力和视网膜敏感度的重要指标。

Relationship between BCVA and macular morphology in patients with diabetic macular edema

AIM:To explore the relationship between the parameters of macular integrity assessment(MAIA), best corrected visual acuity(BCVA)and macular morphology in patients with diabetic macular edema.

METHODS: From March 2018 to January 2020, a total of 43 patients(74 eyes)with diabetic macular edema were randomly selected for treatment in the department of ophthalmology in our hospital.To compare the relationship between MAIA micro field meter parameters and the integrity of macular external membrane, junction of inner and outer photoreceptors(IS/OS)layer and hard exudation. Pearson correlation test was used to analyze the relationship between retinal thickness and retinal sensitivity. Pearson correlation test was used to analyze the correlation between retinal thickness, retinal sensitivity and BCVA in the intact and defect groups of IS/OS layer.

RESULTS: Compared with the IS/OS layer defect group, the levels of BCVA(LogMAR), central retinal thickness(CRT), elliptical area of binary contour 63(BCEA63), elliptical area of binary contour 95(BCEA95)and macular integrity index(MI)in the IS/OS layer intact group were lower, and the levels of average threshold(AT)and P2 were higher(all P<0.01), but there was no significant difference in the levels of central retinal volume(CRV)and P1 between the two groups(all P>0.05). Compared with the external membrane defect group, the levels of BCVA(LogMAR), CRT and MI in the external membrane intact group were lower(all P<0.05), but there was no significant difference in the levels of CRV, AT, P1, P2, BCEA63 and BCEA95 between the two groups(all P>0.05). Compare the group with and without hard exudation, there was no significant difference in eye parameters between the two groups(P>0.05).There was a significant negative correlation between retinal thickness and sensitivity in temporal, central and nasal sides of fovea(P<0.05), but no significant correlation in the upper and lower parts of fovea(P>0.05). In the complete group of IS/OS layer, AT was significantly negatively correlated with CRT and BCVA, while CRT was significantly positively correlated with BCVA(all P<0.05). In the IS/OS layer defect group, there was a significant negative correlation between AT and BCVA(P<0.05).

CONCLUSION:MAIA in the diabetic macular edema is closely related to the morphology and structure of macular area, especially the integrity of IS/OS layer and outer membrane. MAIA may be an important index to evaluate the visual function of patients with diabetic macular edema.