İnsülin rezistansı bulunan bireylerde retina sinir lifi tabakası kalınlığının değerlendirilmesi

Year 2019, , 503 - 508, 30.09.2019

Feyzahan Uzun , Hüseyin Fındık , Hatice Beyazal Polat

https://doi.org/10.31362/patd.544201

Abstract

Amaç:
İnsülin rezistansı tanısı ile takip edilen prediabetik bireylerde retina sinir
lifi kalınlığının (RSLK) ölçümü ve sağlıklı kontrollerle karşılaştırılması.

Gereç-Yöntem: En
iyi düzeltilmiş görme keskinliği, göz içi basıncı, ön segment ve fundus
muayenelerini içeren tam oftalmolojik inceleme yapıldı. RSLK spectral-domain
optik koherans tomografi (OKT) ile ölçüldü. Açlık plazma glikoz ve insülin
seviyeleri not edildi ve insülin rezistans indexi (HOMA-IR) değeri hesaplandı.

Bulgular:
İnsülin rezistansı tespit edilen 37 birey ile 41 sağlıklı kontrol çalışmaya
dahil edildi. Yaş ortalaması insülin rezistansı ve kontrol grubunda sırasıyla
35,7±9,8 ve 34,9±10,7 yıl idi. İnsülin rezistansı olan grupta ortalama
(95,03±11,38 µm vs 99,2±19,73 µm),
inferior (119,11±18,27 µm vs 127,5±21,03
µm) ve temporal (72,13±12,52 µm vs
79,2±15,97 µm) kadranlarda RSLK değeri kontrol grubuna göre istatistiksel
olarak anlamlı derecede ince tespit edildi (p<0,05).
Superior (121,01±9 µm vs 123,9±01
µm) ve nazal (72,03±13,65 µm vs
74,52±10,52 µm) kadranlarda anlamlı bir değişiklik saptanmadı (p˃0,05).

Sonuç:
Prediabetik hastalarda klinik olarak herhangi bir bulgu vermese de retina sinir
lifi tabakasında nörodejenerasyon insülin rezistansı evresinde
başlayabilmektedir. OKT prediabetik bireylerde erken retinal nörodejenerasyon
tanısı ve takibi için uygun bir araçtır.

Keywords

Diabetes mellitus, insülin direnci, optik koherans tomografi

The evaluation of retinal nerve fiber layer thickness in subjects with insulin resistance

Abstract

Purpose: To measure the retinal nerve fiber layer
thickness (RNFLT) in prediabetic subjects who were diagnosed with insulin
resistance and to compare with healthy controls.

Materials
and methods: Each
subject was underwent a standard ophthalmological examination including measurement
of best corrected visual acuity and intraocular pressure, anterior segment
biomicroscopy and funduscopy. Average and four quadrant (superior, temporal,
inferior, nasal) RNFLT measurements were performed using spectral domain
optical coherence tomography (OCT). Plasma fasting insulin and glucose levels
were noted and homeostasis model assessment of insulin resistance index
(HOMA-IR) was calculated.

Results: A
total of 37 patients with insulin resistance and 41 healthy controls were
included in the study. Mean age of the insulin resistant group and healthy
controls were 35.7±9.8 and 34.9±10.7 years, respectively. The average (95.03±11.38 µm vs 99.2±19.73 µm), inferior (119.11±18.27 µm vs 127.5±21.03 µm) and temporal (72.13±12.52 µm vs 79.2±15.97 µm)  quadrant
RNFL were significantly thinner in subjects with insulin resistance as compared
with healthy controls (p<0.05). No significant difference was observed
between the groups in the superior (121.01±9 µm vs 123.9±01 µm) and nasal (72.03±13.65 µm vs 74.52±10.52 µm) quadrants (p˃0.05).

Conclusion: Neurodegeneration
of the retina which is seen in diabetic patients may begin in the insulin
resistance stage. OCT is a useful tool both in the early diagnosis and
follow-up of retinal neurodegeneration.

Keywords

Diabetes mellitus, insulin resistance, optical coherence tomography

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