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Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi

Year 2015, Volume: 22 Issue: 4, 239 - 242, 14.12.2015

Mehmet Ragıp Ekmen

Abstract

Amaç: Diyabetik hastalarda retina içi tabakalardaki nöral değişimlerin tespiti ve bunun erken diyabetik retinopatinin tespitindeki önemini araştırmak.

Gereç veYöntemler: Çalışmaya 100 hastanın 200 gözü dahil edildi. Çalışmaya tip 2 diyabeti olup da diyabetik retinopatisi olmayan 50 hasta (Grup 1) ile diyabeti olmayan 50 kişi kontrol grubu (Grup 2) olarak dahil edildi. Çalışmaya maküla ödemi, proliferatif diyabetik retinopatisi, >+/-6 diyoptrinin üzerindeki refraksiyon kusuru, glokomu, üveiti, oküler cerrahi öyküsü olan hastalar dahil edilmedi. Diyabeti olan hastaların diyabet süreleri, HbA1c düzeyleri kaydedildi. Tüm hastalara tam oftalmolojik muayene, dilate fundus muayenesi ve renkli fundus fotoğrafı, optikal kohorens tomografi (OCT) tetkikleri yapıldı. OCT ‘de maküla kalınlığı (MK), ganglion hücre+iç pleksiform tabaka süperior/inferior (GCC/İPLs/i ), iç nükleer+dış pleksiform tabaka (INL/OPL) kalınlıkları her iki grup için ayrı ayrı ölçülerek kaydedildi.

Bulgular: Çalışmaya katılan 100 hastanın 46’sı erkek, 54’ü kadın idi. Ortalama yaş grup1’de 56,85 (±6,09) grup 2’de 57,19 (±5,045)’idi. Her iki grupta görme keskinlikleri sırasıyla, 0,97±0,15, 0,98±0,12 ortalama göz içi basınçları sırasıyla; 13,54±2,8, 13,68±3,4‘idi. Diyabetik grupta ki hastaların ortalama diyabet süreleri 11,8±1,9 yıl, HbA1c düzeyi 7,2±1,9, idi. Grup 1’de ortalama MK 231µ (±22,75) GCC/İPL s 95,44µ (±11,13), GCC/İPL i 97,15µ (±13,35), INL+OPL 55,19µ (±21,7)’idi. Grup 2’de ortalama MK 232µ (±23,78), GCC+İPLs 96,53µ (±7,4), GCC/İPLi 100,49µ (±9,05), INL/OPL 49,39µ(±20,8)’idi. Her iki grup arasında MK değerleri açısından anlamlı bir fark yoktu(p=0,644). Grup1 ve grup 2 arasında GCC/İPLs,i , INL/OPL değerleri açısından anlamlı fark yoktu (p=0,830, p=0,372, p=0,051).

Sonuç: Diyabetik grupta GCC+İNL kalınlıkları kontrol grubuna göre düşük; INL+OPL değerleri ise kontrol grubuna göre yüksek değerlerde olmasına rağmen her iki grup arasında bu değerler açısından anlamlı bir fark yok idi. Çalışmada OCT’deki GCC/İPL ve INL/OPL değerlerinin erken diyabetik retinopatinin tanısında nöronal hasarın erken teşhisinde tek başına kullanılamayacağı sonucuna varılmıştır.

Anahtar Kelimeler : Diabetik Retinopati; Retina Katmanları; Optikal Kohorens Tomografi.

Keywords

Diabetik Retinopati Retina Katmanları Optikal Kohorens Tomografi

References

  • Girach A, Manner D, and Porta M. Diabetic microvascular complications: Can patients at risk be identified? A review. International Journal of clinical Practice 2006;60:1471-83.
  • Villeroel M, Ciudin A, Hernandez C, and Simo R. Neurodegeneration: An early event of diabetic retinopathy. World Journal of Diabetes 2010;1:57-64.
  • Antonetti DA, Gardner TW. Diabetic retinopathy The New England Journal of Medicine 2012;13:1227-39.
  • Barber AJ, Gardner TW, and Abcouver SF. The significance of vascular and neural apoptosis to the pathology of diabetic retinopathy. Investigate Ophthalmology and Visual Science 2011;2:1156-63.
  • Midena E, Segato T, Guilano M, and Zuchetto M. Macular recovery function in diabetics without and with early retinopathy. British Journal of Ophthalmology 1990;74:106-8.
  • Midena E and Vujosevic S. Visual psychophysiscs in diabetic retinopathy in visual Disfunction in Diabetes, Tink JT, Barbnstable CJ, and Gardner TW, Eds, New York: springer; 2012.p.69-105.
  • Kern TS, and Barber AJ. Retinal ganglion cells in diabetes Journal of physiology 2008;586: 4401-8.
  • Gastinger MJ, Singh RSJ, and Barber AJ. Loss of cholinergic and dopaminergic amacrine cells in streptocine- diabetic rat and ıns2Akıta- diabetic Mouse retinas. Investigative Ophthalmology and Visual Science 2006;47:3143-50.
  • Ly A, Yee P, Vessey KA, Phipps JA, Jobling AI, and Fletcher EL. Early iner retinal astrocyte dysfunction during diabetes and development of hypoxia, retinal stres, and neuronal function loss. Investigative Ophthalmology and Vısual Science 2011;52:9316-26.
  • Van Dijk HW, Kok PHB, Garvin M et al. Selective loss of iner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy. Investigate Ophthalmology and Visual Science 2009;50:3404-9.
  • Debuc DC and Somfai GM. Early detection of retinal thickness changes in diabetes using optical chorence tomography. Medical Science Monitor 2010;16:15-21.
  • Cabera Fernandez D, Somfai GM, Tatrai E et al. Potentiality of intraretinal layer segmentation to locally detect early retinal changes in patients with diabetes mellitus using optical chorence tomography. Investigative Ophthalmology-Vısual Science 2008;49:3105-9.
  • Biallosterski C,Van Velthoven MEJ, Michels RPJ, Schlingmean RO, DeVries JH and Verbraak FD. Decreased optical chorence tomography –measured pericentral retinal thickness in patients with diabetes mellitus type 1 with minimal diabetic retinopathy. British Journal of Ophthalmology 2007;91:1135-8.
  • Van Dijk HW, Verbraak FD, KOK PHB et all. Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes. Investigate Ophthalmology and Visual Science 2010;51:3660-5.
  • Van Dijk HW, Verbraak FD, KOK PHB et all. Selective loss of inner layer thickness in patients in type 1 diabetic patients with minimal diabetic retinopathy. Investigate Ophthalmology and Visual Science 2009;50:3404-9.
  • Vujosevic S, Midena E, Retinal Layer Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations Journal of Diabetes Research 2013;65:1013-8.
  • Bringman A, Iandiew I, Pannicke T et all. Cellular signaling and factors ınvolved in Müller cell gliosis: neuroprotective and detrimental effects. Progress in Retinal and Eye Research 2009;28:423-51.
  • Curtis TM, Hamilton R,Yong P-h-H et all. Müler glial dysfunction during diabetic retinopathy in rats is killed to accumulation of advanced glycation end –products and advanced lipoxidation end-products. Diabetologia 2011;54:690-8.
  • Yong PH, Zong H, Medina RJ et all. Evidence supporting a role for N€-(3 formyl-3,4 dehydropiperidino )lysine accumulation in Müller glia dysfunction and death in diabetic retinopathy. Molecular Vision 2010;16:2524-38.
  • Reichhenbach A, Wurn A, Pannicke T, Iandiev I, Wiedeman P and Bringmann A. Müller cells as players in retinal degeneration and edema. Grafes Archieve for Clinical and Experimental Ophthalmology 2007;245:627-36.
  • Gardner TW, Antonetti DA, Barber AJ, LaNoue KF and Levison SW. Diabetic retinopathy: more than meets the eye. Survey of Ophthalmology 2002;47:253-62.
  • Carrasco E, Hernandez C, Miralles A, Hudget P, Farres J and Simo R. Lower somatostatin expression is an early event in diabetic retinopathy and is associated with retinal neurodegeneration. Diabetes Care 2007;30:2902-8.
  • Carrasco E, Hernandez C, Miralles A, Hudget P, Farres J and Simo R. Lowered cortistatin expression is an early event in the human diabetic retina and is associated with apoptosis and glial activation. Molecular Vision 2008;14:1496-502.

Year 2015, Volume: 22 Issue: 4, 239 - 242, 14.12.2015

Mehmet Ragıp Ekmen

Abstract

References

  • Girach A, Manner D, and Porta M. Diabetic microvascular complications: Can patients at risk be identified? A review. International Journal of clinical Practice 2006;60:1471-83.
  • Villeroel M, Ciudin A, Hernandez C, and Simo R. Neurodegeneration: An early event of diabetic retinopathy. World Journal of Diabetes 2010;1:57-64.
  • Antonetti DA, Gardner TW. Diabetic retinopathy The New England Journal of Medicine 2012;13:1227-39.
  • Barber AJ, Gardner TW, and Abcouver SF. The significance of vascular and neural apoptosis to the pathology of diabetic retinopathy. Investigate Ophthalmology and Visual Science 2011;2:1156-63.
  • Midena E, Segato T, Guilano M, and Zuchetto M. Macular recovery function in diabetics without and with early retinopathy. British Journal of Ophthalmology 1990;74:106-8.
  • Midena E and Vujosevic S. Visual psychophysiscs in diabetic retinopathy in visual Disfunction in Diabetes, Tink JT, Barbnstable CJ, and Gardner TW, Eds, New York: springer; 2012.p.69-105.
  • Kern TS, and Barber AJ. Retinal ganglion cells in diabetes Journal of physiology 2008;586: 4401-8.
  • Gastinger MJ, Singh RSJ, and Barber AJ. Loss of cholinergic and dopaminergic amacrine cells in streptocine- diabetic rat and ıns2Akıta- diabetic Mouse retinas. Investigative Ophthalmology and Visual Science 2006;47:3143-50.
  • Ly A, Yee P, Vessey KA, Phipps JA, Jobling AI, and Fletcher EL. Early iner retinal astrocyte dysfunction during diabetes and development of hypoxia, retinal stres, and neuronal function loss. Investigative Ophthalmology and Vısual Science 2011;52:9316-26.
  • Van Dijk HW, Kok PHB, Garvin M et al. Selective loss of iner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy. Investigate Ophthalmology and Visual Science 2009;50:3404-9.
  • Debuc DC and Somfai GM. Early detection of retinal thickness changes in diabetes using optical chorence tomography. Medical Science Monitor 2010;16:15-21.
  • Cabera Fernandez D, Somfai GM, Tatrai E et al. Potentiality of intraretinal layer segmentation to locally detect early retinal changes in patients with diabetes mellitus using optical chorence tomography. Investigative Ophthalmology-Vısual Science 2008;49:3105-9.
  • Biallosterski C,Van Velthoven MEJ, Michels RPJ, Schlingmean RO, DeVries JH and Verbraak FD. Decreased optical chorence tomography –measured pericentral retinal thickness in patients with diabetes mellitus type 1 with minimal diabetic retinopathy. British Journal of Ophthalmology 2007;91:1135-8.
  • Van Dijk HW, Verbraak FD, KOK PHB et all. Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes. Investigate Ophthalmology and Visual Science 2010;51:3660-5.
  • Van Dijk HW, Verbraak FD, KOK PHB et all. Selective loss of inner layer thickness in patients in type 1 diabetic patients with minimal diabetic retinopathy. Investigate Ophthalmology and Visual Science 2009;50:3404-9.
  • Vujosevic S, Midena E, Retinal Layer Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations Journal of Diabetes Research 2013;65:1013-8.
  • Bringman A, Iandiew I, Pannicke T et all. Cellular signaling and factors ınvolved in Müller cell gliosis: neuroprotective and detrimental effects. Progress in Retinal and Eye Research 2009;28:423-51.
  • Curtis TM, Hamilton R,Yong P-h-H et all. Müler glial dysfunction during diabetic retinopathy in rats is killed to accumulation of advanced glycation end –products and advanced lipoxidation end-products. Diabetologia 2011;54:690-8.
  • Yong PH, Zong H, Medina RJ et all. Evidence supporting a role for N€-(3 formyl-3,4 dehydropiperidino )lysine accumulation in Müller glia dysfunction and death in diabetic retinopathy. Molecular Vision 2010;16:2524-38.
  • Reichhenbach A, Wurn A, Pannicke T, Iandiev I, Wiedeman P and Bringmann A. Müller cells as players in retinal degeneration and edema. Grafes Archieve for Clinical and Experimental Ophthalmology 2007;245:627-36.
  • Gardner TW, Antonetti DA, Barber AJ, LaNoue KF and Levison SW. Diabetic retinopathy: more than meets the eye. Survey of Ophthalmology 2002;47:253-62.
  • Carrasco E, Hernandez C, Miralles A, Hudget P, Farres J and Simo R. Lower somatostatin expression is an early event in diabetic retinopathy and is associated with retinal neurodegeneration. Diabetes Care 2007;30:2902-8.
  • Carrasco E, Hernandez C, Miralles A, Hudget P, Farres J and Simo R. Lowered cortistatin expression is an early event in the human diabetic retina and is associated with apoptosis and glial activation. Molecular Vision 2008;14:1496-502.
There are 23 citations in total.

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Mehmet Ragıp Ekmen This is me

Publication Date December 14, 2015
Published in Issue Year 2015 Volume: 22 Issue: 4

Cite

APA Ekmen, M. R. (2015). Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi. Journal of Turgut Ozal Medical Center, 22(4), 239-242.
AMA Ekmen MR. Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi. J Turgut Ozal Med Cent. December 2015;22(4):239-242.
Chicago Ekmen, Mehmet Ragıp. “Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi”. Journal of Turgut Ozal Medical Center 22, no. 4 (December 2015): 239-42.
EndNote Ekmen MR (December 1, 2015) Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi. Journal of Turgut Ozal Medical Center 22 4 239–242.
IEEE M. R. Ekmen, “Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi”, J Turgut Ozal Med Cent, vol. 22, no. 4, pp. 239–242, 2015.
ISNAD Ekmen, Mehmet Ragıp. “Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi”. Journal of Turgut Ozal Medical Center 22/4 (December 2015), 239-242.
JAMA Ekmen MR. Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi. J Turgut Ozal Med Cent. 2015;22:239–242.
MLA Ekmen, Mehmet Ragıp. “Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi”. Journal of Turgut Ozal Medical Center, vol. 22, no. 4, 2015, pp. 239-42.
Vancouver Ekmen MR. Erken Diyabetik Retinopatide Retina Tabakalarındaki Değişimlerin İncelenmesi. J Turgut Ozal Med Cent. 2015;22(4):239-42.
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