Analysis Of Retinal Vessel Diameter In Patients With Diabetic Macular Edema

ObjectiveTo explore the relations between retinal vascular diameter and diabetic macular edema(DME),and explore the related risk factors of DME to provide more convenient observation indicators for patients and maintain their central vision.MethodsThis study was made up of 91 patients(168 eyes)who were diagnosed with Type 2 Diabetes.Separate all eyes into two groups : DME group and non-DR(NDR)group.According to Fundus fluorescein angiography(FFA)and optical coherence tomography(OCT),168 eyes in DME groups could be separated into three various types,they were diffuse retinal thickening(DRT),cystoid macular edema(CME),and neuroepithelial retinal detachment(NSD)respectively.And the retinal arteriovenous diameter was measured by fundus photographs.Analyze the coherence between retinal vessel diameters and different kinds of DME.Also explain related risk factors of DME,including gender,age,glycosylated hemoglobin(Hb A1c),diabetes course,DR stage,duration of hypertension,blood pressure(BP),blood lipid,body mass index(BMI),serum creatinine(Cr)and blood urea nitrogen(BUN).Results1.Of 75 DME patients(137 eyes),68 eyes(49.64%)with DRT,43 eyes(31.38%)with CME,26eyes(18.98%)with NSD.The average diameters of temporal retinal artery were: NDR group =(11.94 ±1.02)pixels,DRT group =(13.42 ± 0.20)pixels,CME Group =(12.93 ± 0.25)pixels,NSD group =(13.56± 0.37)pixels;The average diameters of temporal retinal vein were: NDR group =(18.05 ± 1.23)pixels,DRT group =(20.31 ± 2.70)pixels,CME Group =(20.10 ± 0.39)pixels,NSD group =(20.35 ± 0.42)pixels.There were significantly differences between DRT,CME,NSD and NDR groups(P < 0.05).And it showed no significant difference among DRT,CME,also NSD groups(P > 0.05).2.The proportion of DR stages: with DRT:28 eyes(41.18%)of mild NPDR,17eyes(25.00%)of moderate NPDR,13 eyes(19.12%)of severe NPDR,and 10 eyes(14.70%)of PDR;With CME: 3 eyes(6.98%)of mild NPDR,14 eyes(32.56%)of moderate NPDR,12 eyes(27.90%)of severe NPDR and 14eyes(32.56%)of PDR;with NSD: 2 eyes(7.69%)of mild NPDR,7 eyes(26.92%)of moderate NPDR,14eyes(53.85%)of severe NPDR and 3 eyes(11.54%)of PDR.The comparison results between groups were:(1)DRT vs CME: P < 0.05;(2)CME vs NSD: P>0.05;(3)DRT vs NSD : P<0.05.There were significant differences between CME and DRT in different DR stages(P < 0.05),also between NSD and DRT.And there was no significant difference between CME and NSD groups(P > 0.05).3.Of 75 DME patients(137 eyes),there were 23 eyes(16.79%)with mild NPDR,38 eyes(27.73%)with moderate NPDR,36 eyes(26.28%)with severe NPDR,and 40 eyes(29.20%)with PDR.The average diameters of temporal retinal artery were: NDR group =(11.94 ± 1.02)pixels,mild NPDR group =(12.43 ± 1.42)pixels,moderate NPDR group =(13.15 ± 1.53)pixels,severe NPDR group =(13.40 ± 1.68)pixels,PDR group =(13.83 ± 1.84)pixels;The average diameters of temporal retinal vein were: NDR group =(18.05 ± 1.23)pixels,mild NPDR group =(19.05 ± 2.17)pixels,moderate NPDR group =(19.90 ±1.63)pixels,severe NPDR group =(20.23 ± 2.44)pixels,PDR group =(21.32 ± 2.44)pixels.The results illustrated that There was no statistic difference in the retinal artery and vein diameters between the mild NPDR group and NDR group;There was significant difference in the moderate NPDR group,severe NPDR group,and PDR group,compared with the NDR group(P < 0.05);There was no significant difference in retinal artery diameter among the moderate NPDR group,severe NPDR group,and PDR group(P > 0.05);There was no statistic difference in retinal vein diameters between the moderate NPDR group and severe NPDR group(P > 0.05),but it was no significant difference between the former two groups and the PDR group in statistics(P < 0.05).4.The dangerous factors associated with DME from in univariate analysis were diabetes duration,Hb A1 c,systolic blood pressure,pulse pressure,and total cholesterol.The above factors were statistically significant difference from NME group(p <0.05).5.Logistic regression analysis maintained that independent dangerous factors for DME were:duration of diabetes(OR =5.373;95%CI 2.274,12.692),Hb A1c(OR =1.634;95%CI 1.004,2.556),Systolic blood pressure(OR = 1.058;95% CI 1.008,1.109),Pulse pressure(OR =1.043;95%CI 1.001,1.088),and total cholesterol(OR =2.144;95%CI 1.185,3.880).Conclusion1.The prevalence rates for DRT are the highest in three DME types,followed by CME and NSD;it had no statistical difference in retinal vessel diameters expansion among three kinds types of DME.2.Three types of DME can occur in different DR stages: DRT mostly occurred in mild to moderate NPDR stages,while the other two types mostly occurred in moderate to severe NPDR and PDR stages.3.The severity of DR is related to diameters of retinal vessel in DME patients(P < 0.05),and DME patients with moderate and severe NPDR and PDR were wider than mild NPDR or NDR,no matter in the diameters of retinal artery or vein.Also,the retinal vein dilated more obviously than the artery.4.The dangerous and independent dangerous factors for DME are inclusive of diabetes duration,Hb A1 c,systolic blood pressure,pulse pressure,and total cholesterol.