天津医药

天津医药 ›› 2023, Vol. 51 ›› Issue (2): 166-170.doi: 10.11958/20220889

• 临床研究 • 上一篇    下一篇

单侧湿性年龄相关性黄斑变性患者患眼黄斑区GCIPL厚度变化及其与血清IL-8水平的关系

张丽君(), 李翔威, 谭晓慧   

  1. 海南医学院第二附属医院眼科（邮编570311）
  • 收稿日期:2022-06-07 修回日期:2022-08-23 出版日期:2023-02-15 发布日期:2023-02-24
  • 作者简介:张丽君（1978），女，副主任医师，主要从事眼部疾病诊疗和健康管理方面研究。E-mail：zlj76990766@163.com
  • 基金资助:
    海南省卫生健康科研项目(21A200144)

The relationship between changes of the macular ganglion cell-inner plexiform layer (GCIPL) thickness of the affected eye in patients with unilateral wet age-related macular degeneration and serum interleukin-8 level

ZHANG Lijun(), LI Xiangwei, TAN Xiaohui   

  1. Department of Ophthalmology, the Second Affiliated Hospital of Hainan Medical University, Haikou 570311, China
  • Received:2022-06-07 Revised:2022-08-23 Published:2023-02-15 Online:2023-02-24

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摘要：

目的 探讨单侧湿性年龄相关性黄斑变性（wetAMD）患者患眼黄斑区神经节细胞-内丛状层（GCIPL）厚度变化及其与血清白细胞介素（IL）-8水平的关系。方法 选取单侧wetAMD患者（wetAMD组）120例，根据荧光素眼底血管造影和吲哚菁绿血管造影检查结果将其分为单侧典型脉络膜新生血管（tCNV）组（45例）以及单侧息肉样脉络膜血管病变（PCV）组（75例）。另选取门诊健康体检眼科检查正常者75例（75眼）作为正常对照组。收集3组受试者的一般资料，并检测研究眼GCIPL厚度参数和血清IL-8水平，比较3组间上述指标的差异。分析GCIPL厚度与血清IL-8水平和wetAMD的关系及其诊断价值。结果 wetAMD组的吸烟比例、伴糖尿病比例以及血清IL-8水平高于对照组，而wetAMD组GCIPL厚度的各测量值均小于正常对照组（均P<0.05）。tCNV组的年龄、吸烟比例、伴糖尿病比例以及血清IL-8水平高于PCV组，而tCNV组GCIPL厚度的各测量值均小于PCV组（均P<0.05）。wetAMD患者患眼GCIPL厚度的各测量值均与血清IL-8水平呈显著负相关（均P<0.05）。多因素Logistic回归分析结果显示，吸烟、糖尿病、平均GCIPL厚度值降低和血清IL-8水平升高是wetAMD发病的危险因素；糖尿病、平均GCIPL厚度值降低和血清IL-8水平升高是wetAMD患者发生tCNV的危险因素（均P<0.05）。平均GCIPL厚度诊断wetAMD的受试者工作特征曲线下面积（AUC）为0.775（95%CI：0.710~0.832），当临界值取75.60 μm时，敏感度为63.33%，特异度为81.33%。平均GCIPL厚度诊断tCNV的AUC为0.765（95%CI：0.678~0.837），当临界值取70.20 μm时，敏感度为64.44%，特异度为82.62%。结论 wetAMD患者患眼GCIPL厚度值异常降低，且与血清IL-8水平升高有关，其对诊断wetAMD和tCNV具有一定辅助价值。

关键词: 湿性黄斑变性, 体层摄影术，光学相干, 视网膜神经节细胞, 白细胞介素8, 脉络膜新生血管化, 息肉样脉络膜血管病变, 神经节细胞-内丛状层

Abstract:

Objective To investigate changes of macular ganglion cell-inner plexiform layer (GCIPL) thickness of the affected eye in patients with unilateral wet age-related macular degeneration (wetAMD) and its relationship with serum interleukin-8 (IL-8) level. Methods A total of 120 patients with unilateral wetAMD were selected as the wetAMD group. According to the test results of fluorescein fundus angiography and indocyanine green angiography, patients were divided into the unilateral typical choroidal neovascularization (tCNV) group (45 cases) and the unilateral polypoid choroidal vasculopathy (PCV) group (75 cases). Seventy-five peoples (75 eyes) with normal ophthalmic examination in clinic physical check-up were enrolled as the normal control group. The general data were collected in the three groups. The GCIPL thickness parameters of studied eyes and the serum level of IL-8 were also detected. The above indicators were compared between the three groups. The relationship between GCIPL thickness, serum IL-8 level and wetAMD was analyzed, and the diagnostic value of GCIPL thickness was also analyzed. Results The proportion of smoking, proportion of diabetes mellitus and serum IL-8 level were significantly higher in the wetAMD group than those in the control group, while each measured value of GCIPL thicknesses in eyes with wetAMD was significantly lower than those in eyes of normal control group (P<0.05). The age, smoking rate, proportion of diabetes mellitus and serum IL-8 level were significantly higher in the tCNV group than those in the PCV group, while each measured value of GCIPL thicknesses in eyes with tCNV was significantly lower than that in the PCV eyes (P<0.05). Each measured value of GCIPL thicknesses in the affected eyes in patients with wetAMD was negatively correlated with serum IL-8 level (P<0.05). Multivariate Logistic regression analysis showed that smoking, diabetes mellitus, the decreased value of average GCIPL thickness and the elevated serum level of IL-8 were risk factors of wetAMD, and diabetes mellitus, the decreased value of average GCIPL thickness and the elevated serum level of IL-8 were risk factors of tCNV in patients with wetAMD (P<0.05). The area under the receiver operating characteristic curve (AUC) of the average GCIPL thickness in the diagnosis of wetAMD was 0.775 (95%CI: 0.710-0.832). When the cut-off value was 75.60 μm, the sensitivity was 63.33% and the specificity was 81.33%. The AUC of the average GCIPL thickness in the diagnosis of tCNV was 0.765 (95%CI: 0.678-0.837). When the cut-off value was 70.20 μm, the sensitivity was 64.44%, and the specificity was 82.62%. Conclusion The GCIPL thickness of the affected eye in patients with unilateral wetAMD is abnormally decreased, which is related to the increased serum level of IL-8, and the GCIPL thickness has certain auxiliary value for the diagnosis of wetAMD and tCNV.

Key words: wet macular degeneration, tomography, optical coherence, retinal ganglion cells, interleukin-8, choroidal neovascularization, polypoidal choroidal vasculopathy, ganglion cell-inner plexiform layer

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