不同OCT分型的糖尿病性黄斑水肿与血小板参数的关系

目的研究不同OCT分型的糖尿病性黄斑水肿(diabetic macular edema,DME)与血小板参数的关系。方法回顾性研究。118例(118眼)糖尿病视网膜病变(diabetic retinopathy,DR)患者中,DME组88眼,未合并DME(Non-DME)组30眼,根据DME的OCT形态分为弥漫性视网膜增厚型(diffuse retinal thickening,DRT)27眼、黄斑囊样水肿(cystoid macular edema,CME)29眼、神经上皮层脱离型(neurosensory retinal detachment,NSD)32眼,对不同组别间患者血小板计数(platelet count,PLT)、平均血小板体积(mean platelet volume,MPV)、血小板平均分布宽度(platelet distribution width,PDW)和血小板压积(plateletcrit,PCT)进行比较,并分析DR分期与DME的OCT分型间的关系。结果DRT在轻度和中度非增生型DR中的占比为50.0%,而NSD在重度非增生型DR及增生型DR患眼中的占比较高,为84.5%。DME组患者的MPV和PDW均明显高于Non-DME组(均为P<0.05),NSD患者的MPV和PDW均明显高于DRT和CME患者(均为P<0.05)。结论不同DME分型的患者MPV、PDW有差异,血小板与NSD的发生、发展可能相关。

Correlation of diabetic macular edema at different morphological patterns by OCT with platelet parameters

Objective　To investigate the relationship between diabetic macular edema (DME) at different morphological patterns by optical coherence tomography (OCT) and platelet parameters.Methods　This retrospective study recruited 118 eyes of 118 patients with diabetic retinopathy (DR), including 88 eyes with DME (DME group) and 30 eyes not accompanying DME (Non-DME group). According to the OCT morphologies of DME, there were 27 eyes with diffuse retinal thickening (DRT), 29 eyes with cystoid macular edema (CME), and 32 eyes with neurosensory retinal detachment (NSD). Platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW) were measured and compared among groups to evaluate the relationship between DR stage and OCT typing of DME. Results　 The proportion of DRT was 50.0% in patients with mild to moderate non-proliferative DR, while proportion of NSD was up to 84.5% in patients with severe non-proliferative DR and proliferative PDR. MPV and PDW in DME group were obviously higher than those in Non-DME group (both P<0.05). MPV and PDW in NSD patients were obviously higher than those in DRT and CME patients (all P<0.05). Conclusion　MPV and PDW are variable among patients having different DME typing. Platelets may be associated with the occurrence and development of NSD.