Retinal Vessel Oxygen Saturation under Flicker Light Stimulation in Patients with Nonproliferative Diabetic Retinopathy
Retinal Vessel Oxygen Saturation under Flicker Light Stimulation in Patients with Nonproliferative Diabetic Retinopathy
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DOI：
10.1167/iovs.12-9659
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发表时间：
2012-06-01
影响因子：
4.4
通讯作者：
Mueller, Ulrich-Alfons
中科院分区：
文献类型：
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作者：
Hammer, Martin;Heller, Tabitha;Mueller, Ulrich-Alfons
目的。方法对18例非增殖型糖尿病视网膜病变患者(平均年龄62.2±8.3岁，其中1型糖尿病4例，2型14例，糖化血红蛋白7.7+/-0.9%，糖尿病病程24.1+/-9.3年)和20例年龄匹配的健康人(年龄66.7±10.3岁)进行视网膜血管内径和血氧饱和度的检测。双波长(548和610 nm)眼底图像在亮度闪烁刺激(12.5 Hz，调制深度>；1：25)前和期间拍摄，持续90秒。结果：闪光使患者视网膜中央动脉(CRAE)、视网膜中央静脉(CRVE)和静脉血氧饱和度(SO2)分别增加0.6±6.6%、2.7±6.1%和2.0±2.4%(P<；0.05)。对照组分别为8.7+/-5.2%(P<；0.05)和4.2+/-3.5%(P<；0.05)。两组动脉血氧分压无明显变化。静脉血中SO2值与CRA值呈显著正相关(P=0.027)。随着体重指数的升高，静脉血中SO2浓度有降低的趋势(P=0.06)。结论我们的研究结果支持糖尿病视网膜氧供应调节受损的观点。而在健康受试者中，神经元活动的刺激增加了血管直径，随后增加了氧气供应，而在糖尿病视网膜病变中，这种增加减少了。这可能暗示内皮功能障碍在该病的病因中所起的作用。(投资眼科VS科学。2012年；53：4063-4068)doi：10.1167/iovs.12-9659
PURPOSE. We investigated the response of retinal vessel diameters and oxygen saturation to flicker light stimulation of neuronal activity in patients with diabetic retinopathy.METHODS. We included 18 patients with nonproliferative diabetic retinopathy (mean age 62.2 +/- 8.3 years, diabetes type 1 in 4 patients and type 2 in 14, hemoglobin A1c 7.7 +/- 0.9%, duration of diabetes 24.1 +/- 9.3 years) and 20 age-matched healthy controls (age 66.7 +/- 10.3 years). Dual wavelength (548 and 610 nm) fundus images were taken before and during luminance flicker stimulation (12.5 Hz, modulation depth > 1: 25) for 90 seconds. Diameters (central retinal arterial [CRAE] and venous [CRVE] equivalents) and oxygen saturation (SO2) were determined, and averaged for all arterioles and venules in an annular area centered at the optic disk.RESULTS. Flicker light increased CRAE, CRVE, and venous SO2 by 0.6 +/- 6.6%, 2.7 +/- 6.1%, and 2.0 +/- 2.4% (P < 0.05), respectively, in the patients as well as 4.7 +/- 8.4% (P < 0.05), 8.7 +/- 5.2% (P < 0.05), and 4.2 +/- 3.5% (P < 0.05), respectively, in the controls. The arterial SO2 remained unchanged in both groups. The increase of the venous SO2 correlated significantly (P = 0.027) with that of the CRAE. There was a trend (P = 0.06) for lower increase of the venous SO2 with higher body mass index.CONCLUSIONS. Our results support the thesis of an impaired regulation of oxygen supply to the diabetic retina. Whereas in healthy subjects the stimulation of neuronal activity increases the vascular diameters and, subsequently, the oxygen supply, this increase is reduced in diabetic retinopathy. This may hint at the role of endothelial dysfunction in the etiology of the disease. (Invest Ophthalmol Vis Sci. 2012;53:4063-4068) DOI:10.1167/iovs.12-9659