Neurodegeneration of the retina in type 1 diabetic patients
Neurodegeneration of the retina in type 1 diabetic patients
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DOI：
10.20452/pamw.1411
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发表时间：
2012-01-01
影响因子：
--
通讯作者：
Wierusz-Wysocka, Bogna
中科院分区：
文献类型：
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作者：
Araszkiewicz, Aleksandra;Zozulinska-Ziolkiewicz, Dorota;Wierusz-Wysocka, Bogna
前言视网膜神经元和神经胶质细胞的变性最近被假定在糖尿病视网膜病变的发病机制。光学相干断层扫描（OCT）允许进行视网膜厚度（RT）的定性和定量测量，并识别各个视网膜层。神经节细胞层（GCL）OCT在有和无临床诊断的视网膜病变的1型糖尿病患者中获得的厚度。糖尿病患者（39名男性，38名女性;中位年龄，35岁[四分位距（IQR），29-42];中位病程，10年[IQR，9-14]）和31名年龄和性别匹配的对照组。我们测量了视网膜中央凹、视网膜旁凹和中央凹周围的RT，以及RNFL和GCL厚度。我们将糖尿病患者分为2个亚组，即，结果与对照组相比，糖尿病组中心凹周围视网膜增厚（P = 0.05），平均RNFL（P = 0.002），下RNFL（P < 0.0001），上级和下GCL（P = 0.05和P = 0.04）。我们在23例糖尿病患者（29%）中检测到视网膜病变。与无视网膜病变的患者相比，有视网膜病变的患者的视网膜旁视网膜更薄（P = 0.05），平均RNFL（P = 0.002），下和鼻RNFL（P = 0.002，P = 0.03），上级（P = 0.05）和下GCL（P = 0.006）。糖尿病病程与鼻侧RNFL厚度（r =-0.32，P = 0.004）和视网膜旁RT（r =-0.47，P = 0.001）相关。糖尿病视网膜病变的神经变性与病程密切相关。
INTRODUCTION The degeneration of retinal neurons and glial cells has recently been postulated in the pathogenesis of diabetic retinopathy. Optical coherence tomography (OCT) allows to perform qualitative and quantitative measurements of retinal thickness (RT) with identification of individual retinal layers.OBJECTIVES We compared RT, retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer (GCL) thickness obtained by OCT in type 1 diabetic patients with and without clinically diagnosed retinopathy.PATIENTS AND METHODS The study included 77 consecutive patients with type 1 diabetes (39 men, 38 women; median age, 35 years [interquartile range (IQR), 29-42]; median disease duration, 10 years [IQR, 9-14]) and 31 age-and sex-matched controls. We measured RT in the fovea, parafovea, and perifovea, as well as RNFL and GCL thickness. We divided diabetic patients into 2 subgroups, i.e., those with diabetic retinopathy and without retinopathy.RESULTS We observed thicker perifoveal retina (P = 0.05), mean RNFL (P = 0.002), inferior RNFL (P < 0.0001), and superior and inferior GCL (P = 0.05 and P = 0.04, respectively) in diabetic subjects compared with the control group. We detected retinopathy in 23 diabetic patients (29%). Compared with patients without retinopathy, subjects with retinopathy had thinner parafoveal retina (P = 0.05), mean RNFL (P = 0.002), inferior and nasal RNFL (P = 0.002, P = 0.03), superior (P = 0.05) and inferior GCL (P = 0.006). Significant correlations were found between duration of diabetes and nasal RNFL thickness (r = -0.32, P = 0.004) and parafoveal RT (r = -0.47, P < 0.001).CONCLUSIONS The results might suggest the loss of intraretinal neural tissue in type 1 diabetic patients with retinopathy. Neurodegeneration in diabetic retinopathy is closly associated with disease duration.