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EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS

Yıl 2019, Cilt: 20 Sayı: 1, 14 - 18, 25.02.2019
https://doi.org/10.18229/kocatepetip.532105

Öz

The present study aimed to compare the choroidal thickness of the patients diagnosed with type 1 diabetes mellitus (DM) with no sign of diabetic retinopathty (DR) in the endocrinology policlinic and with the choroidal thickness of healthy subjects.

MATERIAL AND METHODS: The patients were screened at horizontal level using spectral domain optical coherence tomography device (Nidek SLO/Spectral OCT (RS 3000)). Choroidal thickness was measured from a total of seven points in the subfoveal area horizontally at 600μm intervals to a distance of 1200 μm in the nasal and temporal quadrants. The patients with type 1 diabetes were assigned to Group 1 and the control subjects were assigned to Group 2. Patients with corneal opacity, cataract, retinal disease, family history of glaucoma or history of ocular surgery, uncontrolled hypertension, and cardiovascular disorders were excluded.

RESULTS: The study comprised 20 eyes of 10 Type 1 DM patients without DR and 16 eyes of eight control subjects. No significant difference was determined between the groups in terms of age, gender, spherical equivalent, best corrected visual acuity, intraocular pressure and axial length. In Group 1, subfoveal choroidal thickness was 311.6μm in the right eye and 348.7μm in the left eye. In Group 2, subfoveal choroidal thickness was 377.1μm in the right eye and 368.9μm in the left eye. The choroidal thickness has become thinner in the nasal vs. temporal quadrant both in Group 1 and Group 2 (p=0.039). Comparing the choroidal thickness between the groups, it was found to be higher in Group 2, but the difference was not statistically significant (p=0.214).

CONCLUSIONS: Type 1 diabetes mellitus has more aggressive impacts on the eye than those of type 2 diabetes, but it appears to have lower impact on the choroid, which is rich in vascular structure. Although choroidal thickness was determined to be decreased in type 1 diabetes mellitus, the results were not statistically significant. We assume that the results might change in case the data is augmented with larger number of type 1 diabetes mellitus patients. Moreover, manual measurement of choroidal thickness using SD-OCT may give different results.

Kaynakça

  • 1.Norris A.W, Wolfsdorf J.I. Diabetes Mellitus. In: Brook G.D.C,Clayton P.E, Brown RS, Savage M.O (eds). Clinical Pediatric Endocrinology. 5 edition. Massachusetts (USA): Blackwell Publishing Ltd; 2005:436-91. 18
  • 2. Marçal AC, Leonelli M, Fiamoncini J, et al. Diet-inducedobesity impairs AKT signaling in the retina and causes retinal degeneration. Cell Biochem Funct. 2013;31:65-74.
  • 3. Moss SE, Klein R, Klein BE. The 14-year incidence of visual loss in a diabetic population. Ophthalmology. 1998; 105:998–1003.
  • 4. Koca C, Altan N, Dinçel AS, Kosova F, Şahin D, Arslan M. Tip 1ve Tip 2 Diyabetik Hasta Serumlarında Oksidatif Stres ve Leptin Düzeylerinin incelenmesi. Türk Klinik Biyokimya Derg 2008; 6(3): 99-107.
  • 5. Hidayat AA, Fine BS. Diabetic choroidopathy. Lightand electron microscopic observations of seven cases. Ophthalmology. 1985; 92:512–522.
  • 6.Cao J, McLeod S, Merges CA, Lutty GA. Choriocapillarisdegeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol. 1998; 116:589–597.
  • 7.Reiner A, Del Mar N, Zagvazdin Y, Li C, Fitzgerald ME. Agerelated impairment in choroidal blood flow compensation for arterial blood pressure fluctuation in pigeons. Invest Ophthalmol Vis Sci 2011; 52: 7238–47.
  • 8. Nagaoka T, Kitaya N, Sugawara R, et al. Alteration of cho¬roidal circulation in the foveal region in patients with type 2 diabetes. Br J Ophthalmol. 2004;88:1060-63
  • 9. Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond. Surv Ophthalmol. 2013;58:387-429.
  • 10. Xu J, Xu L, Du KF, et al. Subfoveal choroidal thicknessin diabetes and diabetic retinopathy. Ophthalmology. 2013;120:2023-28.
  • 11. Regatieri CV, Branchini L, Carmody J, et al. Choroidalthickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina Phila Pa. 2012;32:563-8.
  • 12. Çıtırık M, İlhan Ç, Teke MY. Optik Koherens Tomografi. Güncel Retina 2017;1(1):58-68.
  • 13. Yolcu U, Çağıltay E, Toyran S, Akay F, Uzun S, GündoğanFC. Coroidal and macular thickness in tip 1 diabetes mellitus patients without diabetic retinopathy. Postgraduate medicine 2016;128(8):755-760.
  • 14. Querques G, Lattanzio R, Querques L, et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes. Invest Ophthalmol Vis Sci. 2012;53:6017–6024.
  • 15. Sayın N, Kara N, Pirhan D, Vural A, Ersan HB, Onal H. Evaluation of subfoveal choroidal thickness in children with tip 1 diabetes mellitus:an edi OCT study. Seminars in opthalmolology. 2014;29:27-31.
  • 16.Esmaeelpour M, Brunner S, Ansari-Shahrezaei S, et al.Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060 nm optical coherence tomography. Investigative Ophthalmology & Visual Science. 2012;53: 6803-6809.
  • 17.Sezer T, Altınışık M, Koytak İA, Özdemir MH, koroid ve optikkoherans tomografi, turk J Opthalmol. 2016;46:30-37.
  • 18.Unsal E, Eltutar K, Zirtiloğlu S, et al. Choroidal thicknessin patients with diabetic retinopathy. Clin Ophthalmol. 2014;8:637–642.
  • 19. Kim JT, Lee DH, Joe SG, et al. Changes in choroidalthickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci. 2013;54:3378–3384

TİP 1 DİYABETES MELLİTUS HASTALARINDA SUBFOVEAL KOROİD KALINLIĞININ SPEKTRALİS OCT İLE DEĞERLENDİRİLMESİ

Yıl 2019, Cilt: 20 Sayı: 1, 14 - 18, 25.02.2019
https://doi.org/10.18229/kocatepetip.532105

Öz

ÖZAMAÇ: Bu çalışmada amacımız, endokrin kliniğince tip 1 diyabetes mellitus (DM) tanısı konulmuş herhangi bir diyabetik retinopati (DR) bulgusu olmayan olgularla, sağlıklı bireylerin koroid tabakası kalınlıklarını karşılaş-tırmaktır.
GEREÇ VE YÖNTEM: Olguların spektral domain optical chorence tomografi cihazı (Nidek SLO/Spectral OCT(RS 3000))ile horizontal düzlemde taraması yapıldı. Koroid kalınlıklarını foveada, nazal ve temporalde horizontal olarak 600μm aralıklarla 1200 μm mesafaye kadar toplam 7 noktada ölçümler yapıldı. Tip 1 diyabet olan hastalar grup 1, kontrol grubu ise grup 2 olarak sınıflandırıldı. Korneal opasite, katarakt, retinal hastalık, ailede glokom ve oküler cerrahi öyküsü, kontrolsüz hipertansiyon, kardiyovasküler bozukluk olan hastalar çalışmaya dahil edilmedi. BULGULAR: Çalışmaya DR’si olmayan 10 tip 1 DM hastasının 20 gözü ile 8 kontrol grubunun 16 gözü dahil edildi. Yaş, cinsiyet, sferik ekivalan, düzeltilmiş en iyi görme keskinliği, göz içi basıncı ve aksiyel uzunluk değerlerinde gruplar arasında anlamlı farklılık saptanmadı. (Grup 1)’de subfoveal koroidal kalınlık sağ gözde 311.6μm sol gözde 348.7μm olarak bulundu. (Grup 2)’de subfoveal koroidal kalınlık sağ gözde377.1μm sol gözde 368.9μm olarak ölçülmüştür. Hem grup 1 hem de grup 2 de koroid kalınlığının nazalde temporale göre daha ince olduğu bulunmuştur (p=0.039). Her iki grubun koroid kalınlıkları karşılaştırıldığında grup 2 de koroid kalınlıklarının daha yüksek olduğu bulunmasına karşın veriler arasındaki fark istatistiki olarak anlamlı bulunmamıştır (P=0.214).SONUÇ: Tip 1 diyabetes mellitusun göze olan etkileri tip 2 diyabetten daha ağır seyretmesine rağmen, vasküler yapı yönünden zengin olan koroid üzerine etkisi daha az gibi görünmektedir. Tip 1 diyabette koroid kalınlığında azalma olduğu tespit edilse de sonuçlar istatistiki olarak anlamlı bulunmamıştır. Tip 1 diyabetes mellitusu olan daha fazla hasta ile veri sayısının artırılması durumunda sonuçlarda değişiklik olabileceği düşünülmektedir. Ayrıca SD-OKT cihazları ile koroid kalınlığı ölçümünün manuel olarak yapılması sonuçların farklı çıkmasına neden olabilmektedir.

Kaynakça

  • 1.Norris A.W, Wolfsdorf J.I. Diabetes Mellitus. In: Brook G.D.C,Clayton P.E, Brown RS, Savage M.O (eds). Clinical Pediatric Endocrinology. 5 edition. Massachusetts (USA): Blackwell Publishing Ltd; 2005:436-91. 18
  • 2. Marçal AC, Leonelli M, Fiamoncini J, et al. Diet-inducedobesity impairs AKT signaling in the retina and causes retinal degeneration. Cell Biochem Funct. 2013;31:65-74.
  • 3. Moss SE, Klein R, Klein BE. The 14-year incidence of visual loss in a diabetic population. Ophthalmology. 1998; 105:998–1003.
  • 4. Koca C, Altan N, Dinçel AS, Kosova F, Şahin D, Arslan M. Tip 1ve Tip 2 Diyabetik Hasta Serumlarında Oksidatif Stres ve Leptin Düzeylerinin incelenmesi. Türk Klinik Biyokimya Derg 2008; 6(3): 99-107.
  • 5. Hidayat AA, Fine BS. Diabetic choroidopathy. Lightand electron microscopic observations of seven cases. Ophthalmology. 1985; 92:512–522.
  • 6.Cao J, McLeod S, Merges CA, Lutty GA. Choriocapillarisdegeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol. 1998; 116:589–597.
  • 7.Reiner A, Del Mar N, Zagvazdin Y, Li C, Fitzgerald ME. Agerelated impairment in choroidal blood flow compensation for arterial blood pressure fluctuation in pigeons. Invest Ophthalmol Vis Sci 2011; 52: 7238–47.
  • 8. Nagaoka T, Kitaya N, Sugawara R, et al. Alteration of cho¬roidal circulation in the foveal region in patients with type 2 diabetes. Br J Ophthalmol. 2004;88:1060-63
  • 9. Mrejen S, Spaide RF. Optical coherence tomography: imaging of the choroid and beyond. Surv Ophthalmol. 2013;58:387-429.
  • 10. Xu J, Xu L, Du KF, et al. Subfoveal choroidal thicknessin diabetes and diabetic retinopathy. Ophthalmology. 2013;120:2023-28.
  • 11. Regatieri CV, Branchini L, Carmody J, et al. Choroidalthickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina Phila Pa. 2012;32:563-8.
  • 12. Çıtırık M, İlhan Ç, Teke MY. Optik Koherens Tomografi. Güncel Retina 2017;1(1):58-68.
  • 13. Yolcu U, Çağıltay E, Toyran S, Akay F, Uzun S, GündoğanFC. Coroidal and macular thickness in tip 1 diabetes mellitus patients without diabetic retinopathy. Postgraduate medicine 2016;128(8):755-760.
  • 14. Querques G, Lattanzio R, Querques L, et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes. Invest Ophthalmol Vis Sci. 2012;53:6017–6024.
  • 15. Sayın N, Kara N, Pirhan D, Vural A, Ersan HB, Onal H. Evaluation of subfoveal choroidal thickness in children with tip 1 diabetes mellitus:an edi OCT study. Seminars in opthalmolology. 2014;29:27-31.
  • 16.Esmaeelpour M, Brunner S, Ansari-Shahrezaei S, et al.Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060 nm optical coherence tomography. Investigative Ophthalmology & Visual Science. 2012;53: 6803-6809.
  • 17.Sezer T, Altınışık M, Koytak İA, Özdemir MH, koroid ve optikkoherans tomografi, turk J Opthalmol. 2016;46:30-37.
  • 18.Unsal E, Eltutar K, Zirtiloğlu S, et al. Choroidal thicknessin patients with diabetic retinopathy. Clin Ophthalmol. 2014;8:637–642.
  • 19. Kim JT, Lee DH, Joe SG, et al. Changes in choroidalthickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci. 2013;54:3378–3384
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler-Araştırma Yazıları
Yazarlar

Özgür Eroğul

Leyla Eryiğit Eroğul Bu kişi benim

Yayımlanma Tarihi 25 Şubat 2019
Kabul Tarihi 28 Mayıs 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 20 Sayı: 1

Kaynak Göster

APA Eroğul, Ö., & Eryiğit Eroğul, L. (2019). EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS. Kocatepe Tıp Dergisi, 20(1), 14-18. https://doi.org/10.18229/kocatepetip.532105
AMA Eroğul Ö, Eryiğit Eroğul L. EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS. KTD. Şubat 2019;20(1):14-18. doi:10.18229/kocatepetip.532105
Chicago Eroğul, Özgür, ve Leyla Eryiğit Eroğul. “EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS”. Kocatepe Tıp Dergisi 20, sy. 1 (Şubat 2019): 14-18. https://doi.org/10.18229/kocatepetip.532105.
EndNote Eroğul Ö, Eryiğit Eroğul L (01 Şubat 2019) EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS. Kocatepe Tıp Dergisi 20 1 14–18.
IEEE Ö. Eroğul ve L. Eryiğit Eroğul, “EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS”, KTD, c. 20, sy. 1, ss. 14–18, 2019, doi: 10.18229/kocatepetip.532105.
ISNAD Eroğul, Özgür - Eryiğit Eroğul, Leyla. “EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS”. Kocatepe Tıp Dergisi 20/1 (Şubat 2019), 14-18. https://doi.org/10.18229/kocatepetip.532105.
JAMA Eroğul Ö, Eryiğit Eroğul L. EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS. KTD. 2019;20:14–18.
MLA Eroğul, Özgür ve Leyla Eryiğit Eroğul. “EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS”. Kocatepe Tıp Dergisi, c. 20, sy. 1, 2019, ss. 14-18, doi:10.18229/kocatepetip.532105.
Vancouver Eroğul Ö, Eryiğit Eroğul L. EVALUATION OF SUBFOVEAL CHOROIDAL THICKNESS USING SPECTRALIS OCT IN THE PATIENTS WITH TYPE 1 DIABETES MELLITUS. KTD. 2019;20(1):14-8.

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