Peripapillary circulatory dysfunction precedes structural loss in treatment-naive diabetic retinopathy
Peripapillary circulatory dysfunction precedes structural loss in treatment-naive diabetic retinopathy
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初治糖尿病视网膜病变中视乳头周围循环功能障碍先于结构丧失
DOI：
10.1007/s00417-022-05773-9
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Susumu Ishida
中科院分区：
文献类型：
--
作者：
Mizuho Mitamura;Hiroaki Endo;Satoru Kase;Zhenyu Dong;Mitsuo Takahashi;Satoshi Katsuta;Manabu Kase;Susumu Ishida
目的本研究的目的是比较功能和结构参数之间的视乳头周围血管损伤的时间，并检查它们在糖尿病视网膜病变（DR）不同阶段与神经血管耦合的参与情况。方法纳入143例2型糖尿病（DM）患者的190只眼和88例健康对照眼。 DM患者的眼睛被分为3个阶段：无糖尿病视网膜病变（NDR）、非增殖性糖尿病视网膜病变（NPDR）和增殖性糖尿病视网膜病变（PDR）。 NPDR 和 PDR 眼睛未曾接受治疗。 OCT 血管造影用于计算径向乳头周围毛细血管 (RPC) 通量指数 (FI) 和 RPC 灌注密度 (PD)。使用谱域 OCT 测量相应 RPC 区域内的视网膜神经纤维层 (RNFL) 厚度。结果与对照眼相比，NDR 眼的 RPC-FI 显着下降，此后在 DM（NDR、NPDR 和 PDR）眼中保持不变。相比之下，对照眼和 NDR 眼之间的 RPC-PD 保持不变，并且在 NPDR 眼中显着下降，其次是 PDR 眼，水平相似。从对照眼到 NPDR 眼，RNFL 厚度与 RPC-FI 和 RPC-PD 均呈正相关，表明功能和结构神经血管耦合。这些血管参数在对照眼和 NPDR 眼中也相互相关，但在 NDR 眼中则不然，这与功能参数和结构参数之间血管损伤时间的差异一致。 结论 在 DR 阶段进展期间，循环功能障碍先于结构损失，同时维持视乳头周围神经血管耦合。在检测 DR 的早期血管损伤方面，RPC-FI 可能比 RPC-PD 更敏感。
PurposeThe aim of this study was to compare the timing of peripapillary vascular damage between functional and structural parameters and examine their involvement with neurovascular coupling at different stages of diabetic retinopathy (DR).MethodsOne hundred ninety eyes of 143 patients with type 2 diabetes mellitus (DM) and 88 healthy control eyes were enrolled. Eyes of DM patients were divided into 3 stages with no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). NPDR and PDR eyes were treatment-naive. OCT angiography was used to calculate radial peripapillary capillary (RPC)-flux index (FI) and RPC-perfusion density (PD). Spectral domain OCT was used to measure retinal nerve fiber layer (RNFL) thickness within the corresponding RPC areas.ResultsRPC-FI significantly decreased in NDR eyes compared to control eyes and thereafter remained unchanged among DM (NDR, NPDR, and PDR) eyes. In contrast, RPC-PD stayed unaltered between control and NDR eyes and significantly decreased in NPDR followed by PDR eyes at similar levels. From control to NPDR eyes, RNFL thickness showed positive correlations with both RPC-FI and RPC-PD, indicative of functional and structural neurovascular coupling. These vascular parameters were also correlated with each other in control and NPDR eyes but not NDR eyes, consistent with the difference in the timing of vascular damage between functional and structural parameters.ConclusionsCirculatory dysfunction preceded structural loss while maintaining peripapillary neurovascular coupling during progression of DR stages. RPC-FI would likely be more sensitive than RPC-PD in detecting early vascular damage in DR.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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DOI：
--
发表时间：
1995-09
期刊：
The American journal of pathology
影响因子：
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作者：
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