功能性糖尿病视网膜病变:一种新的概念,以改善糖尿病视网膜疾病的管理
Bhim B Rai1, Ted Maddess1, Christopher J Nolan2
1John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia.
Survey of ophthalmology
|November 24, 2024
概括
多焦点功能测试对于早期检测功能性糖尿病视网膜病变 (FDR) 至关重要,这是结构变化之前的疾病. 整合这些测试可以改善糖尿病视网膜病变和黄斑的管理,防止视力丧失.
科学领域:
- 眼科医生 眼科 眼科
- 糖尿病学 糖尿病学
- 神经科学是一个神经科学.
背景情况:
- 糖尿病视网膜病变 (DR) 和糖尿病黄斑 (DME) 的管理目前依赖于检测结构和血管变化.
- 由于糖尿病视网膜神经退行症 (DRN) 的功能性视力损失可以在可检测的血管病变和结构损伤之前发生.
- 目前的诊断方法,如 funduscopy, fundus摄影,和OCT可能会错过早期的功能缺陷,特别是当DME掩盖视网膜稀薄时.
研究的目的:
- 突出多焦点功能测试在管理DR和DME方面的重要性.
- 引入功能性糖尿病视网膜病变 (FDR) 的概念,并倡导其早期检测.
- 建议目前的查指南不足以检测广泛的功能障碍.
主要方法:
- 审查当前的DR/DME管理指南.
- 关于糖尿病视网膜神经退行症 (DRN) 和DR/DME功能缺陷的文献综述.
- 分析现有诊断工具的局限性 (眼底镜,OCT,最佳校正视力敏度).
主要成果:
- 功能性视力损失发生在临床DR症状和结构变化之前.
- 目前的DR/DME管理侧重于晚期结构异常,忽视早期功能缺陷.
- 最好的视力敏度校正,这是唯一推的功能测试,仅评估一个小的视网膜中心区域 (<1%).
- 多焦点功能测试可以客观地评估中央和外围视网膜功能.
结论:
- 目前的DR/DME查不足以检测影响更宽视网膜的FDR.
- 使用多焦点功能测试早期发现FDR可以推进管理策略.
- 实施功能测试可以通过专注于患者的功能结果,帮助预防危及视力的并发症.
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