網膜症のない糖尿病と高血圧の網膜神経線維層に及ぼす影響

Influence of systemic hypertension and diabetes mellitus without retinopathy on the thickness of retinal nerve fiber layer

要約　目的：高血圧と糖尿病が網膜神経線維層に及ぼす影響の報告。対象と方法：網膜神経線維層厚を380例380眼で検索した。内訳は，高血圧がない糖尿病114眼，高血圧がある糖尿病62眼，10年以上前からの高血圧と網膜血管硬化症がある69眼，正常135眼である。糖尿病群はいずれも網膜症を認めない。網膜神経線維層厚の計測には光干渉断層計（OCT2）を使い，計測部位は乳頭周囲，耳側，上側，下側，鼻側とした。測定値の評価には年齢を考慮した。結果：網膜神経線維層厚の平均値は，高血圧眼では正常眼と有意差がなく，糖尿病眼では高血圧の有無にかかわらず正常眼よりも有意に低値であった。重回帰分析で，網膜神経線維層厚は正常眼では加齢によりわずかに減少し，糖尿病眼では高血圧の有無にかかわらずやや強く減少した。結論：年齢と糖尿病は網膜神経線維層厚に影響を及ぼすが，高血圧は影響しにくい。

Abstract.　Purpose：To report the influence of hypertension and diabetes mellitus on retinal nerve fiber layerthickness（RNFLT）. Cases and Method：RNFLT was measured in 380 eyes of 380 persons. The series comprised diabetes mellitus with and without hypertension 62 and 114 eyes respectively,hypertension for 10 years or longer with retinal arteriosclerosis 69 eyes,and 135 normal eyes. There was no eye with diabetic retinopathy in the series. An optical coherence tomography（OCT 2）was used to measure RNFLT around,superior,temporal,inferior and nasal to the optic disc. Results：There was no significant difference in the average value of RNFLT between eyes with systemic hypertension and control. Average value of RNFLT was significantly less in diabetic eyes with or without hypertension than in control. It slightly decreased in normal eyes along with age and moderately decreased in diabetic eyes regardless of presence of hypertension. Conclusion：RNFLT decreases in the presence of diabetes mellitus and along with age. It is not affected by systemic hypertension.