Electroretinography and retinal microvascular changes in type 2 diabetes
Electroretinography and retinal microvascular changes in type 2 diabetes
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DOI：
10.1111/aos.14421
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发表时间：
2020-04-04
影响因子：
3.4
通讯作者：
Park, Young-Hoon
中科院分区：
文献类型：
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作者：
Kim, Mirinae;Kim, Rae-Young;Park, Young-Hoon
目的探讨糖尿病视网膜电生理参数与视网膜微血管结构参数变化的关系。方法对380例糖尿病患者和160例健康对照者进行前瞻性队列研究。根据糖尿病视网膜病变（DR）早期到晚期的严重程度，分析视网膜电图（ERG）参数和光学相干断层扫描（OCT）血管造影获得的血管参数。入组时的平均年龄为65.4 ± 7.8岁，177例（33.84%）为男性。与对照组相比，糖尿病患者眼的视杆细胞、视锥细胞和联合反应ERG b波的振幅和隐式时间均显著降低和延长。暗视和联合反应b波的振幅与浅丛血管密度（VD）呈正相关，隐式时间与浅丛VD呈负相关。有趣的是，电生理参数和深VD之间没有相关性。这些电生理参数和血管参数之间的相关性并不显着，在非糖尿病，健康对照group.Conclusions功能和结构障碍之前的DR的临床表现。我们还发现，这些神经损伤，通过ERG评估，与浅表VD。然而，这种相关性在健康和早期DR组中不存在。这些发现仔细地表明，神经元功能障碍与2型糖尿病的血管功能障碍有关。
Purpose To assess whether functional (electrophysiological) parameters are related to changes in the structural (microvascular) parameters in diabetic retina.Methods This prospective cohort study included 380 eyes of patients with diabetes mellitus (DM) and 160 eyes of healthy controls. We analysed the electroretinogram (ERG) parameters and vascular parameters acquired from optical coherence tomography (OCT) angiography according to the diabetic retinopathy (DR) severity from early to late stages of DR.Results After exclusion, 366 eyes of diabetes and 157 eyes of controls were included in the analysis. The mean age at enrolment was 65.4 +/- 7.8 years, and 177 (33.84%) were male. The amplitude and implicit time of the rod and cone and combined response ERG b-wave were significantly reduced and prolonged in the eyes of patients with DM, compared to the controls. There was a positive correlation between the amplitude and vessel density (VD) of the superficial plexus and a negative correlation between the implicit time and superficial VD in the scotopic and combined response b-wave. Interestingly, there was no correlation between electrophysiological parameters and deep VD. These correlations between electrophysiological parameters and vascular parameters were not significant in the non-diabetic, healthy control group.Conclusions Functional and structural impairments precede the clinical manifestation of DR. We also found that these neural impairments, evaluated by ERG, were correlated with superficial VD. However, this correlation was absent in the healthy and early DR groups. These findings carefully suggest that neuronal dysfunction is linked to vascular dysfunction in type 2 diabetes.