目的：探讨糖尿病黄斑水肿(diabetic macular edema，DME)患者视力与椭圆体带完整性的相关性及视力的相关影响因素。

方法：纳入糖尿病视网膜病变(diabetic retinopathy，DR)合并DME患者39例62眼，根据频域光学相干断层扫描(spectral domain optical coherence tomography，SD-OCT)技术测量的椭圆体带破坏程度进行分组：A组椭圆体带完整连续，B组椭圆体带缺损长度≤200μm，C组椭圆体带缺损长度>200μm。测量三组患者的最佳矫正视力(best corrected visual acuity，BCVA)和黄斑中心凹视网膜厚度(central macular thickness，CMT)，观察是否存在浆液性视网膜脱离(serous retinal detachment，SRD)和硬性渗出(hard exudates，HE)等。采用Pearson相关法分析年龄、性别、糖尿病病程、HbA1c、DME病程和类型、DR分期、椭圆体带缺损长度、是否存在SRD和HE等因素与BCVA的相关性。

结果：治疗前三组患者BCVA分别为0.44±0.18、0.64±0.16、0.74±0.21，差异有统计学意义(P<0.001)。三组患者CMT分别为403.40±90.32、408.44±95.98、421.29± 98.32μm，差异无统计学意义(P=0.805)。Pearson相关分析提示，椭圆体带缺损长度、CMT均与BCVA呈负相关(r=-0.673、-0.344，均P<0.001)，且椭圆体带缺损长度与BCVA呈强相关，CMT与BCVA呈弱相关，其它因素如SRD、HE、DME病程等均与BCVA无明显相关性。

结论：椭圆体带的完整性与BCVA存在较强的相关性，CMT与BCVA存在弱相关性。

METHODS: We studied 62 eyes of 39 patients with DME. Using spectral domain optical coherence tomography(SD-OCT), disrupted elipsode zone length were measured, and the eyes were categorized into three groups according to elipsode zone: 1)Group A: with a completely visible elipsode zone; 2)Group B: with a disrupted elipsode zone and the length of disruption within 200μm;(3)Group C: with a disrupted elipsode zone and the length of disruption longer than 200μm. We also evaluated the presence or absence of hard exudates(HE), serous retinal detachment(SRD), central macular thickness(CMT)using SD-OCT. Pearson analysis testing was performed over the BCVA and the elipsode zone integrity, CMT, existence of SRD and HE, age, sex, duration of diabetes, HbA1c, duration of DME, stage of diabetic retinopathy, and DME type.

RESULTS: Before treatment, BCVA(LogMAR)in the Group A(0.44±0.18)or Group B(0.64±0.16)was significantly better than that in the Group C(0.74±0.21)(P<0.001). CMT had no difference between Group A(403.40±90.32μm), Group B(408.44±95.98μm)or Group C(421.29± 98.32μm, P=0.805). Analysis showed that elipsode zone integrity had close correlation coefficient with BCVA(r=-0.673, P<0.001), CMT had weak correlation with BCVA(r=-0.344, P<0.001). Other factors SRD, HE and duration of DME did not correlate with BCVA.

CONCLUSION: The integrity of elipsode zone are closely associated with BCVA in DME. CMT are weakly associated with BCVA in DME.