| Objective: To determinate the different duration of diabetic mellitus of retinal nerve fiber layer(RNFL) thickness by using optical coherence tomography (OCT), how to analyze the relationships between the course of diabetes mellitus and RNFL.Method: 97 patients suffed type 2 diabetes were selected from the Affiliated Hospital of Dali Medical University,including male (n=59) and female (n=38), age: 55.55±10.56 years. And 20 healthy volunteers were selected as control group, including male(n=10) and female(n=10), age:49.5±8.59years. One eye was randomly selected as the research object. According to the duration of diabetic mellitus, they were divided into A group (duration <5 years), group B (5 years <duration<10 years), group C (10 years <duration <15 years), group D (duration >15 years). All the subjects were investigated by the questionnaire to understand the history and treatment of DM, and we have recorded we also record the rusult of the weight, blood pressure, fasting blood glucose, hemoglobin A1c, blood lipids and so on. To understand the vision, intraocular pressure, slit lamp examination ,the retinal and RNFL thickness though OCT check. We can observe the changes of RNFL thickness among of groups by RNFL thickness and the correlation among the parameters.Result: 1. The comparison of RNFL: There was no significant difference between the DM group and the control group in the nasal RNFL, while the other quadrants of mean thickness of RNFL decreased with the increase of duration of diabetic mellitus.Compared with the control group, there was no significant difference between normal control group and A, B group (P >0.05). Compared with C group and D group, the difference was statistically significant in the superior and mean RNFL thickness (P<0.05),The RNFL thickness of D group in the inferior and temple quadrant was statistically significant.We also compared the thickness of RNFL within groups, there are stastic difference in the superior quadrant among A, C, D groups, and in the inferior quadrant among B, C and Dgroups, and in the inferior quadrant between B and C groups, and in the nasal and temple quadrant respectively.2. Correlation between the risk factors and RNFL thicknessCorrelation of each parameter: Body mass index, fasting blood glucose, hemoglobin A1c,diastolic blood pressure, blood lipid indexes (TG, LDL, HDL and TC) were not significantly correlated with RNFL thickness. Systolic blood pressure was negatively correlated with the superior , inferior quadrant and mean RNFL thickness (r=-0.253,P <0.05) . There was, the higher systolic blood pressure, and there was the thinner was the inferior quadrant RNFL thickness.3.The relationship among RNFL and duration of diabetes, diabetic mellitus stage and the use of insulinCorrelation with RNFL thickness: The duration of diabetic mellitus and stage of diabetic retinopathy (DR) were negatively correlated with the inferior quadrant RNFL thickness (r=-0.242, -0.282, P <0.05) . There are no correlation between the use of insulin and RNFL thickness with the longer duration of diabetic mellitus,there is more the severce condition and the thinner inferior quadrant RNFL thickness.Conclusion: 1.With the prolongation of the duration of diabetic mellitus, the thickness of RNFL had the trend of thinner. The thickness of RNFL was asymmetry thinner with the prolongation of the duration of diabetic mellitus. We are evaluate the damage of retinal ganglion cells with prolongation of the duration of diabetic mellitus by monitoring the thickness of RNFL,which may be valuable for clinical treatment and follow-up of diabetic mellitus. 2. The inferior quadrant RNFL thickness is thinner with the prolongation of the duration of diabetic mellitus and the severity of diabetic retinopathy. 3. The research shows that to control of systolic blood pressure can protect the inferior quadrant RNFL. |
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