Systemic and Ocular Determinants of Choroidal Structures on Optical Coherence Tomography of Eyes with Diabetes and Diabetic Retinopathy
Systemic and Ocular Determinants of Choroidal Structures on Optical Coherence Tomography of Eyes with Diabetes and Diabetic Retinopathy
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DOI：
10.1038/s41598-019-52750-0
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发表时间：
2019-11-07
影响因子：
4.6
通讯作者：
Mitamura, Yoshinori
中科院分区：
文献类型：
--
作者：
Kinoshita, Takamasa;Imaizumi, Hiroko;Mitamura, Yoshinori
了解糖尿病和糖尿病视网膜病变（diabeticretinopathy，DR）患者的脉络膜结构有助于了解DR的发病机制。本研究旨在探讨影响糖尿病患者脉络膜结构的全身和眼部因素。200例连续糖尿病受试者包括160例未经治疗的不同阶段DR患者和40例既往接受过全视网膜光凝（PRP）的增殖性DR患者。所有患者均接受了血液和尿液检查以及增强型深度成像光学相干断层扫描（EDI-OCT）。对中心凹下脉络膜的横截面EDI-OCT图像进行二值化，以测量总脉络膜面积（TCA）、管腔面积和基质面积。进行多变量回归分析，以确定与脉络膜结构显著相关的全身和眼部因素。视网膜病变晚期黄斑中心凹下脉络膜厚度、TCA、管腔面积和基质面积均大于无视网膜病变的黄斑中心凹下脉络膜厚度、TCA、管腔面积和基质面积，而PRP组黄斑中心凹下脉络膜厚度、TCA、管腔面积和基质面积均小于无视网膜病变的黄斑中心凹下脉络膜厚度、TCA、管腔面积和基质面积（P < 0.001）。TCA和基质面积与蛋白尿程度呈显著正相关（分别为P = 0.034，P = 0.025）。随着DR的进展，脉络膜腔和基质可能增加，PRP后减少。蛋白尿可能与脉络膜基质水肿有关。
Knowledgeof the choroidal structures in eyes with diabetes and diabetic retinopathy (DR) should provide information on the pathogenesis of DR. A prospective study was performed to determine the systemic and ocular factors that affect the choroidal structures in eyes with diabetes. Two-hundred consecutive diabetic subjects consisted of 160 treatment-naive patients with different stages of DR and 40 patients with proliferative DR with prior panretinal photocoagulation (PRP). All underwent blood and urine tests and enhanced depth imaging optical coherence tomography (EDI-OCT). The cross-sectional EDI-OCT images of the subfoveal choroid were binarized to measure the total choroidal area (TCA), luminal area, and stromal area. Multivariate regression analyses were performed to determine the systemic and ocular factors that were significantly correlated with the choroidal structures. The subfoveal choroidal thickness, TCA, luminal area, and stromal area were larger at more advanced stage of DR, and smaller in eyes with PRP than those without (P < 0.001). The TCA and stromal area were significantly and positively correlated with the degree of albuminuria (P = 0.034, P = 0.025, respectively). The choroidal lumen and stroma may increase as the stages of DR progress and decrease after PRP. Albuminuria may be associated with the choroidal stromal edema.