Macular and peripapillary retinal nerve fiber layer thinning in eyes with prediabetes in the elderly population: OTASSHA study
Macular and peripapillary retinal nerve fiber layer thinning in eyes with prediabetes in the elderly population: OTASSHA study
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DOI：
10.1007/s00417-022-05925-x
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发表时间：
2022-12-01
影响因子：
2.7
通讯作者：
Ueta，Takashi
中科院分区：
文献类型：
--
作者：
Toyama，Taku;Kawai，Hisashi;Ueta，Takashi
目的探讨老年糖尿病前期（preDM）和2型糖尿病无视网膜病变（non-diabetic retinopathy，NDR）患者的视网膜厚度参数。根据HbA 1c水平将患眼分为非糖尿病组（606眼）、糖尿病前期组（480眼）和NDR组（187眼）。进行眼底照相、扫频光源光学相干断层扫描和全面的系统检查。黄斑（mRNFL）和视乳头周围（pRNFL）中的视网膜神经纤维层、神经节细胞复合体（GCC）和神经节细胞内丛状层（GCIPL）的厚度，结果糖尿病前期mRNFL的厚度明显变薄，与非糖尿病组相比，差异有统计学意义（P < 0.05），与糖尿病组相比，差异有统计学意义（P < 0.05）。糖尿病和NDR与糖尿病前期在3/6个部门。在2/12个扇区中，在preDM与非DM和NDR与preDM中观察到pRNFL显著变薄。这种糖尿病阶段依赖性变薄的RNFL主要观察到在颞部和上级部门。GCIPL和GCC对反映DM依赖性视网膜内层变薄的敏感性较低。CST和CFT与DM分期无明显相关性。结论颞叶和上级mRNFL变薄可能是preDM和NDR早期神经退行性变的敏感指标。
PurposeTo investigate retinal thickness parameters in the elderly with prediabetes mellitus (preDM) and type 2 DM without retinopathy (non-diabetic retinopathy [NDR]).MethodsThis cross-sectional study included a total of 1273 eyes without retinal pathologies of 699 volunteers aged ≥ 65 years were included. The eyes were categorized into non-DM (606 eyes), preDM (480 eyes), and NDR (187 eyes) groups according to their HbA1c levels. Fundus photography, swept-source optical coherence tomography, and comprehensive systemic examination were conducted. The thicknesses of the retinal nerve fiber layer in the macula (mRNFL) and peripapillary (pRNFL), ganglion cell complex (GCC), and ganglion cell inner plexiform layer (GCIPL), as well as central subfield thickness (CST) and central foveal thickness (CFT) were investigated for their association with DM stage using linear mixed model.ResultsA statistically significant thinning of mRNFL was observed in preDM vs. non-DM and in NDR vs. preDM in 3/6 sectors. A significant thinning of pRNFL was observed in preDM vs. non-DM and in NDR vs. preDM in 2/12 sectors. Such DM stage–dependent thinning of RNFL was observed mainly in the temporal and superior sectors. GCIPL and GCC were less sensitive to reflect DM-dependent inner retinal thinning. CST and CFT were not significantly associated with different DM stages.ConclusionThe thinning of mRNFL in the temporal and superior sectors might be a sensitive parameter associated with early neurodegeneration in preDM and NDR.