Clinical Research

The clinical effect of the whole process blood glucose management on improving postoperative vision in T2DM cataract patients with non-diabetic retinopathy based on visual electrophysiology and OCTA study

  • Juan TANG ,
  • Fen LAN ,
  • Linxia MENG ,
  • Qinqin ZHANG ,
  • Chuanqiang DAI ,
  • Zheng LEI ,
  • Qilin FANG ,
  • Ying LI ,
  • Xiaoli WU ,
  • Tao. LI
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Received date: 2024-07-19

  Online published: 2024-11-05

Abstract

Objective Visual electrophysiology and optical correlation tomography angiography (OCTA) were used to investigate differences in preoperative retinal function in patients with type 2 diabetic cataract (DC) without obvious retinopathy (NDR) and to determine the clinical application of whole-process blood glucose management (WBGM) for improving postoperative vision in DC patients. Methods This study investigated the preoperative and postoperative visual electrophysiology (N75, P100, photopic FERG, and scotopic FERG), peripapillary retinal nerve fiber layer (pRNFL) and peripapillary capillary vessel density (ppVD) data, as well as trends in these data changes during blood glucose management intervention. Results As the course of T2DM progressed, FBG and HbA1c increased, the N75 and P100 lategraduancy periods of patients gradually lengthened, and the photopic FERG, scotopic FERG, pRNFL, and ppVD values decreased at each postoperative time point. At the same time, the best corrected visual acuity (BCVA) of patients after surgery gradually decreased (P < 0.05). Compared with that at 1 week after surgery, the BCVA of Group A (without whole-process blood glucose management) gradually increased at 1 month and 3 months after surgery but showed a downward trend at 1 year after surgery. The BCVA of Group B (with whole-process blood glucose management) gradually stabilized at 1 month after surgery, and at all time points after surgery, the BCVA of Group B was better than that of Group A. The results showed that N75 and P100 in Group A were greater than those in Group B, while the photopic and scotopic FERG, pRNFL, and ppVD (%) in Group A were lower than those in Group B. In addition, N75 and P100 in Group A showed a gradual prolongation trend at various time points after surgery, while photopic FERG, scotopic FERG, pRNFL, and ppVD (%) showed a gradually decreasing trend. However, the above data in Group B gradually stabilized at 3 months after DC surgery, approaching the preoperative level of the group (P < 0.05). In the state of whole blood glucose management, although N75 and P100 both reached their longest durations at 1 week after surgery, N75, P100, photopic FERG, scotopic FERG, and pRNFL showed a gradually decreasing trend at 1 month and 3 months after surgery, while ppVD (%) gradually increased (P < 0.05). At various time points from 3 months to 1 year after surgery, the overall trend of the above indicators remained stable and close to the preoperative values (P > 0.05). Conclusion According to the results of the quantitative analysis of visual electrophysiology and OCTA, in DC patients without obvious retinopathy and with the worsening of diabetes, retinal function decreased, but whole-process blood glucose management effectively restored retinal function and improved visual quality after surgery.

Cite this article

Juan TANG , Fen LAN , Linxia MENG , Qinqin ZHANG , Chuanqiang DAI , Zheng LEI , Qilin FANG , Ying LI , Xiaoli WU , Tao. LI . The clinical effect of the whole process blood glucose management on improving postoperative vision in T2DM cataract patients with non-diabetic retinopathy based on visual electrophysiology and OCTA study[J]. The Journal of Practical Medicine, 2024 , 40(20) : 2888 -2899 . DOI: 10.3969/j.issn.1006-5725.2024.20.012

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