Einfluss der makulären Ischämie auf funktionelle und morphologische Parameter bei Patienten mit diabetischer Retinopathie

Influence of macular ischemia on functional and morphological parameters in patients with diabetic retinopathy

von Greta Zinser
Dissertation
Datum der mündl. Prüfung:2021-08-04
Erschienen:2021-08-04
Betreuer:Prof. Dr. Nicolas, Feltgen
Gutachter:Prof. Dr. Nicolas Feltgen
Gutachter:Prof. Dr. Dirk Raddatz
Gutachter:Prof. Dr. Margarete Schön
Zum Verlinken/Zitieren: http://dx.doi.org/10.53846/goediss-8744

 

 

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Zusammenfassung

Englisch

The aim of the present study was to investigate the influence of macular ischaemia on functional and morphological retinal parameters in patients with diabetic retinopathy. In particular, the aim of this study was to demonstrate correlations between the various examination parameters and the size of the ischaemic area in the foveal avascular zone (FAZ). The background is the wish to be able to establish improved early diagnostics for the detection of diabetic maculopathy with the help of a possible correlation. For the study, a total of 40 diabetics of different ages and types were examined and 36 patients with a complete data set were included in the analysis. Refraction, visual acuity, contrast vision and visual field size were determined. OCT examination and fluorescein angiography were also performed for each patient. Each of these measured parameters was correlated with the size of the macular ischaemia. The evaluation showed significant correlations between the macular ischaemia area on the one hand and individual parameters (contrast visual acuity, visual field defect size and total macular volume) on the other hand. With increasing macular ischaemia, contrast vision deteriorates and the size of the visual field defect increases. In addition, it was shown that with an increase in ischaemia area, both layer thickness and central retinal volume increase. Visual acuity, on the other hand, was not significantly altered. However, a precise definition of a visually reducing damaged ischaemic area was not possible. Thus, no clear boundary can be defined beyond which a macula is associated with irreversible loss of function. In summary, the study showed that the parameters contrast vision, relative central scotoma and macular volume in OCT correlate with macular ischaemia. If one wants to identify possible central ischaemic patients in the context of a screening with functional and simple image morphological methods, these three examination methods are suitable and clearly superior to the measurement of visual acuity.
Keywords: diabetic retinopathy; macular ischemia; visual acuity; optical coherence tomography; fluorescein angiography
 
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