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Diabetes Care:微动脉瘤更替预测临床意义黄斑水肿

2012-12-12 Diabetes Care Diabetes Care

微动脉瘤黄斑水肿糖尿病视网膜病变
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　　葡萄牙学者的一项研究表明，在伴有非增殖性糖尿病视网膜病变（NPDR）的糖尿病患者中，微动脉瘤更替可预测具临床意义黄斑水肿（CSME）形成。论文于2012年11月30日在线发表于《糖尿病护理》（Diabetes Care）。 　　此项前瞻性、单中心、观察性研究共纳入410例伴NPDR的糖尿病患者。受试者既往均未接受激光治疗，并接受2年随访或至CSME形成。在基线、6个月和最后访视（2

　　葡萄牙学者的一项研究表明，在伴有非增殖性糖尿病视网膜病变（NPDR）的糖尿病患者中，微动脉瘤更替可预测具临床意义黄斑水肿（CSME）形成。论文于2012年11月30日在线发表于《糖尿病护理》（Diabetes Care）。

　　此项前瞻性、单中心、观察性研究共纳入410例伴NPDR的糖尿病患者。受试者既往均未接受激光治疗，并接受2年随访或至CSME形成。在基线、6个月和最后访视（24各月或激光治疗前）实施包括最佳校正视力、眼底照相和光学相干断层成像在内的眼科学检查。

　　结果显示，共有26例患者出现CSME。基线HbA1c水平和随访最初6个月内微动脉瘤更替（即合计微动脉瘤形成和消失率）为CSME形成的独立预测因素。在形成和未形成CSME的患者中，微动脉瘤更替分别为11.2±11.2和5.0±5.2（P<0.001）。微动脉瘤高更替值与早期形成CSME具有相关性，阳性和阴性预测值分别为20%和96%。




OBJECTIVE 
To examine the relationship between microaneurysm (MA) turnover using automated analysis of fundus photographs (RetmarkerDR; Critical Health SA) and development of clinically significant macular edema (CSME) in nonproliferative diabetic retinopathy (NPDR).
RESEARCH DESIGN AND METHODS 
A prospective, monocenter, observational study was designed to follow eyes/patients with type 2 diabetes and NPDR (Early Treatment Diabetic Retinopathy Study levels 20 and 35) with no prior laser treatment for 2 years or until development of CSME. A total of 410 patients, one eye per patient, fulfilled the inclusion/exclusion criteria and were included in the study. Ophthalmologic examinations including best corrected visual acuity, fundus photography, and optical coherence tomography were performed at baseline, 6 months, and at the last study visit (24 months or before laser treatment).
RESULTS 
A total of 348 eyes/patients performed the 24-month visit or developed CSME. Of these 348 eyes/patients, 26 developed CSME. HbA1c levels at baseline and MA turnover (i.e., the sum of the MA formation and disappearance rates) computed during the first 6 months of follow-up were found to be independently predictive factors for development of CSME. MA turnover was 11.2 ± 11.2 in the 26 eyes/patients that developed CSME and 5.0 ± 5.2 in the remaining 322 (P < 0.001). Higher MA turnover values correlated with earlier development of CSME. MA turnover predictive values for CSME development were, for the positive predictive value, 20% and for the negative predictive value, 96%.
CONCLUSIONS 
MA turnover calculated with the RetmarkerDR predicts development of CSME in eyes with NPDR. Low MA turnover values identify well the eyes that are less likely to develop CSME in a 2-year period.
    

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    2013-11-20 木头人513

    #Diabetes#

    0

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    2013-02-20 ms5439512287675881

    #BET#

    0

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    2013-03-16 ms9608593228839890

    #DIA#

    0

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    2012-12-14 小华子

    #水肿#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1901036, encodeId=e4561901036cb, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Wed Nov 20 00:36:00 CST 2013, time=2013-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759228, encodeId=db2c1e5922833, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Feb 20 02:36:00 CST 2013, time=2013-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636606, encodeId=ada31636606fa, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 16 04:36:00 CST 2013, time=2013-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333312, encodeId=865c1333312fc, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri Dec 14 07:36:00 CST 2012, time=2012-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510889, encodeId=00851510889d2, content=<a href='/topic/show?id=abd8103141b8' target=_blank style='color:#2F92EE;'>#黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103141, encryptionId=abd8103141b8, topicName=黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9a10269982, createdName=xiay994456, createdTime=Fri Dec 14 07:36:00 CST 2012, time=2012-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525046, encodeId=8208152504672, content=<a href='/topic/show?id=65e91031337f' target=_blank style='color:#2F92EE;'>#黄斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103133, encryptionId=65e91031337f, topicName=黄斑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=638b11619344, createdName=muzishouyi, createdTime=Fri Dec 14 07:36:00 CST 2012, time=2012-12-14, status=1, ipAttribution=)]
    2012-12-14 xiay994456

    #黄斑水肿#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1901036, encodeId=e4561901036cb, content=<a href='/topic/show?id=c097591ed5' target=_blank style='color:#2F92EE;'>#Diabetes#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5917, encryptionId=c097591ed5, topicName=Diabetes)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0045169, createdName=木头人513, createdTime=Wed Nov 20 00:36:00 CST 2013, time=2013-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759228, encodeId=db2c1e5922833, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Feb 20 02:36:00 CST 2013, time=2013-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1636606, encodeId=ada31636606fa, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Mar 16 04:36:00 CST 2013, time=2013-03-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333312, encodeId=865c1333312fc, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri Dec 14 07:36:00 CST 2012, time=2012-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510889, encodeId=00851510889d2, content=<a href='/topic/show?id=abd8103141b8' target=_blank style='color:#2F92EE;'>#黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103141, encryptionId=abd8103141b8, topicName=黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9a10269982, createdName=xiay994456, createdTime=Fri Dec 14 07:36:00 CST 2012, time=2012-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525046, encodeId=8208152504672, content=<a href='/topic/show?id=65e91031337f' target=_blank style='color:#2F92EE;'>#黄斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103133, encryptionId=65e91031337f, topicName=黄斑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=638b11619344, createdName=muzishouyi, createdTime=Fri Dec 14 07:36:00 CST 2012, time=2012-12-14, status=1, ipAttribution=)]
    2012-12-14 muzishouyi

    #黄斑#

    0