Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness of Patients With Type 2 Diabetes
Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness of Patients With Type 2 Diabetes
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DOI：
10.1001/jamaophthalmol.2019.2537
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发表时间：
2019-10-01
影响因子：
8.1
通讯作者：
Kim, Jung Yeul
中科院分区：
文献类型：
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作者：
Lim, Hyung Bin;Shin, Yong Il;Kim, Jung Yeul
重要性2型糖尿病预计会加速与年龄相关的视乳头周围视网膜神经纤维层（pRNFL）的损失，但有关2型糖尿病患者pRNFL厚度减少率的信息有限。研究对象：63例健康人和101例2型糖尿病患者的164只眼（49例无DR患者[非DR组]和52例轻度至中度非增殖性DR患者[NPDR组]）从2013年1月2日起入组这项前瞻性、纵向、观察性研究，至2015年2月27日。随访3年，每隔1年测量视乳头周围平均和扇形RNFL厚度。使用线性混合模型估计pRNFL丢失的平均速率，并在3组之间进行比较。随访于2018年3月16日完成，数据分析于2018年4月2日至7月27日。暴露2型糖尿病。主要结局和指标2型糖尿病患者pRNFL厚度降低率。（88名女性[53.7%];平均[SD]年龄，58.2 [8.7]岁）被纳入研究分析。对照组的平均（SD）年龄为56.5（9.3）岁（39例女性[61.9%]）;非DR组为59.1（9.4）岁（26例女性[53.1%]）; NPDR组为59.4（11.0）岁（23例女性[44.2%]）。非DR组2型糖尿病的平均（SD）持续时间为7.1（4.4）年，NPDR组为13.2（8.4）年。对照组的基线平均（SD）pRNFL厚度为96.2（11.0）μ m，非DR组为93.5（6.4）μ m，NPDR组为90.4（7.9）μ m。在3年的随访中，这些值在对照组中降至95.0（9.2）μ m，在非DR组中降至90.3（6.4）μ m，在NPDR组中降至86.6（7.9）μ m。在线性混合模型中，非DR组的估计平均pRNFL丢失为-0.92 μ m/y（P
IMPORTANCE Type 2 diabetes is expected to accelerate age-related peripapillary retinal nerve fiber layer (pRNFL) loss, but limited information on the rate of reduction in pRNFL thicknesses in patients with type 2 diabetes is available.OBJECTIVE To investigate longitudinal changes in pRNFL thickness in patients with type 2 diabetes, with or without diabetic retinopathy (DR).DESIGN, SETTING, AND PARTICIPANTS A total of 164 eyes of 63 healthy individuals and 101 patients with type 2 diabetes (49 patients without DR [non-DR group] and 52 patients with mild to moderate nonproliferative DR [NPDR group]) were enrolled in this prospective, longitudinal, observational study from January 2, 2013, through February 27, 2015. Participants were followed up for 3 years, and the peripapillary mean and sector RNFL thicknesses were measured at 1-year intervals. The mean rate of pRNFL loss was estimated using a linear mixed model and compared among the 3 groups. Follow-up was completed on March 16, 2018, and data were analyzed from April 2 through July 27, 2018.EXPOSURE Type 2 diabetes.MAIN OUTCOMES AND MEASURES The rate of reduction in pRNFL thickness in patients with type 2 diabetes.RESULTS A total of 164 participants (88 women [53.7%]; mean [SD] age, 58.2 [8.7] years) were included in the study analysis. The mean (SD) age of the control group was 56.5 (9.3) years (39 women [61.9%]); the non-DR group, 59.1 (9.4) years (26 women [53.1%]); and the NPDR group, 59.4 (11.0) years (23 women [44.2%]). Mean (SD) duration of type 2 diabetes was 7.1 (4.4) years in the non-DR group and 13.2 (8.4) years in the NPDR group. The baseline mean (SD) pRNFL thickness was 96.2(11.0) mu m in the control group, 93.5(6.4) mu m in the non-DR group, and 90.4(7.9) mu m in the NPDR group. During 3 years of follow-up, these values decreased to 95.0(9.2) mu m in the control group, 90.3(6.4) in the non-DR group, and 86.6(7.9) mu m in the NPDR group. In a linear mixed model, the estimated mean pRNFL loss was -0.92 mu m/y in the non-DR group (P