目的 研究糖尿病患者是否存在视网膜神经纤维层(retinal nerve fiber layer,RNFL)的变薄,并分析RNFL厚度和若干糖尿病危险因素之间的相关性.方法 42位2型糖尿病患者(47～70岁)被纳入该研究.所有患者接受常规眼科检查和GDxVCC神经纤维分析仪检查(包括可变角膜补偿模式VCC和强化角膜补偿模式ECC).GDx测量参数包括:颞侧-上方-下方-鼻侧-颞侧平均(TSNITave),上方平均(Superiorave),下方平均(Inferiorave),TSNIT标准差(TSNITstdDev)和神经纤维指数(NFI).通过计算受试者工作曲线(ROC)分析各指标的诊断能力,并研究相关危险因素与NFI值之间的关系.结果 在ECC和VCC检测模式下,NFI值的ROC曲线下面积均是最大的.年龄增长和视网膜神经纤维层变薄之间存在统计学意义的相关性.然而,在糖尿病病程和空腹血糖与RNFL 厚度之间未发现具统计学意义的相关性.年龄对糖尿病患者的NFI检测值的影响大于对正常对照人群NFI值的影响.结论 年龄因素对糖尿病患者的NFI值具有重要影响.眼底尚表现正常的糖尿病患者可能已存在视网膜神经纤维层变薄.%Objective To investigate whether there is a thinning of the retinal nerve fiber layer (RNFL) in the eyes of diabetic patients and to analyze the relationship between RNFL thickness and several diabetic risk factors. Methods Forty-two type 2 diabetes mellitus patients aged 47-70 years were enrolled in this study. All the subjects underwent ophthalmologic examinations and glaucoma diagnosis (GDx) nerve fiber analyzer scanning with two different modes: variable cornea compensation (VCC) and enhanced cornea compensation(ECC).The GDx parameters included the temporal-superior-nasal-inferior-temporal average (TSNITave), superior and inferior averages, the TSNIT standard deviation and the nerve fiber indicator (NFI). The receiver operating characteristic (ROC) was applied to study the diagnostic ability of indices. The association between risk factors and the NFI was studied. Results The area under the curve for the ROC of the NFI was the largest for both the ECC and VCC modes. There was a significant relationship between age and RNFL thinning. However, there was no significant association between diabetic duration and fasting blood glucose with RNFL thinning. The influence of age on NFI was greater in diabetic patients than in control subjects. Conclusions Age has an important influence on the NFI of diabetic patients. Diabetic patients with normal ocular fundus may have RNFL thinning.
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