目的： 探讨2型糖尿病患者眼轴长度与糖尿病视网膜病变(DR)的相关性。

方法：横断面研究。选取2023-01/05期间在济宁市第一人民医院眼科住院的2型糖尿病患者53例104眼，其中2例为独眼患者只纳入1眼，其余患者均双眼入组。根据是否有眼底病变分为无糖尿病视网膜病变(NDR)组32眼和DR组72眼，DR组患者根据眼底病变程度分为非增殖型糖尿病视网膜病变(NPDR)组27眼和增殖型糖尿病视网膜病变(PDR)组45眼。将DR组患者眼轴长度按照四分位法分为四组：20.00～22.09mm组19眼，22.10～22.70mm组17眼； 22.71～23.12mm组18眼； 23.13～24.48mm组18眼。采用二元Logistic回归分析影响DR、PDR发生的因素。

结果：经二元Logistic回归分析后显示，眼轴长度、年龄均是影响DR和PDR发生的因素(眼轴长度：OR=0.296，95%CI：0.130～0.672，P<0.05； OR=0.237，95%CI：0.076～0.736，P<0.05； 年龄：OR=0.949，95%CI：0.907～0.994，P<0.05； OR=0.879，95%CI：0.820～0.942，P<0.05)。眼轴为23.13～24.48mm组患者PDR患病风险较眼轴为20.00～22.09mm组降低(OR=0.057； 95%CI：0.006～0.515，P=0.011)。

结论：2型糖尿病患者眼轴越长，糖尿病患者越不容易出现DR，同时DR也越不容易进展为PDR，长眼轴是DR的保护性因素。

METHODS:This study is a cross-sectional study. A total of 53 cases(104 eyes)of type 2 diabetes patients who admitted to the ophthalmology department of the Jining No.1 People's Hospital between January and May 2023 were included. Among these cases, 51 patients had both eyes included, while 2 patients had only one eye included. The patients were divided into two groups based on the presence or absence of fundus lesions. The non-diabetic retinopathy(NDR)group consisted of 32 eyes, and the DR group consisted of 72 eyes. Within the DR group, the patients were further categorized based on the severity of fundus lesions. The non-proliferative diabetic retinopathy(NPDR)group comprised of 27 eyes, and the proliferative diabetic retinopathy(PDR)group consisted of 45 eyes. The axial lengths of eyes in the DR group were divided into four groups using quartiles: 19 eyes in the 20.00～22.09 mm group, 17 eyes in the 22.10～22.70 mm group, 18 eyes in the 22.71～23.12 mm group, and 18 eyes in the 23.13～24.48 mm group. Binary Logistic regression analysis was employed to investigate the factors influencing the occurrence of DR and PDR.

RESULTS:Binary Logistic regression analysis showed that both axial length and age significantly influenced the development of DR and PDR.(Axial length: OR=0.296, 95%CI:0.130～0.672, P<0.05; OR=0.237, 95%CI:0.076～0.736, P<0.05; age: OR=0.949, 95%CI:0.907～0.994, P<0.05; OR=0.879, 95%CI: 0.820～0.942, P<0.05). The risk of PDR in the group with axial length of 23.13～24.48 mm was reduced compared to the group with axial length of 20.00～22.09 mm(OR=0.057; 95%CI: 0.006～0.515, P=0.011).

CONCLUSION:The findings indicate that longer axial length in patients with type 2 diabetes are associated with a decreased risk of developing DR, as well as a reduced likelihood of DR progressing to PDR. Therefore, a long axial length can be considered a protective factor against DR.