Early neurovascular changes in the retina in preclinical diabetic retinopathy and its relation with blood glucose.
Early neurovascular changes in the retina in preclinical diabetic retinopathy and its relation with blood glucose.
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DOI：
10.1186/s12886-021-01975-7
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发表时间：
2021-05-17
影响因子：
2
通讯作者：
Guo L
中科院分区：
文献类型：
--
作者：
Li H;Yu X;Zheng B;Ding S;Mu Z;Guo L
探讨糖尿病视网膜病变临床前期视网膜神经纤维层厚度和黄斑区血流密度的变化及其与血糖的关系。本研究选取97例糖尿病患者（共188只眼，其中无糖尿病视网膜病变组144只眼，轻度糖尿病非增殖性视网膜病变组44只眼）和35例健康人（共70只眼），根据HbA1c水平进行分组，并进行光学相干断层扫描血管造影。比较不同葡萄糖浓度组的光学相干断层扫描血管造影参数和视网膜神经纤维层厚度。糖尿病组视网膜旁血管密度和颞侧视网膜神经纤维层厚度均低于正常组（P < 0.05）。糖尿病组血管无循环指数高于正常组。正常组血管密度最高，无环指数最低，其次为非糖尿病视网膜病变组和轻度非增殖性视网膜病变组（P < 0.001）。中心凹血管密度和视网膜旁血管密度随HbA1c升高而降低。视网膜深血管层视网膜旁血管密度与空腹血糖呈负相关（P < 0.01）。视网膜神经纤维层厚度随HbA1c水平的升高而降低，并与视网膜浅血管层血管密度呈正相关（p < 0.05）。这项研究表明，视网膜微血管病变和神经病变可以在没有视网膜病变的情况下存在。视网膜深血管层血管密度与空腹血糖呈负相关，视网膜神经纤维层厚度与视网膜浅血管层血管密度呈正相关。这些指标有助于内分泌科和眼科医生发现早期糖尿病视网膜病变。
To investigate the changes in retinal nerve fiber layer thickness and macular blood flow density during the preclinical stage of diabetic retinopathy and their relationship with blood glucose. In this cross-sectional study, 97 diabetic patients (total of 188 eyes; 144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different groups based on their HbA1c levels, and they underwent optical coherence tomography angiography. We compared the optical coherence tomography angiography parameters and retinal nerve fiber layer thickness among the different glucose groups. The parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (p < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index than the normal group. The normal group had the highest vessel density and the lowest acircularity index, followed by the no-diabetic retinopathy group and the mild non-proliferative retinopathy group, (p < 0.001). Foveal vascular density and parafoveal vessel density decreased with an increase in HbA1c. There was a negative correlation between parafoveal vessel density in the deep retinal vascular layer and fasting blood glucose (p < 0.01). The temporal retinal nerve fiber layer thickness decreased across the HbA1c level groups, and was positively correlated with the parafoveal vessel density in the superficial retinal vascular layer (p < 0.05). This study shows that retinal microvasculopathy and neuropathy can be present in the absence of retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal retinal nerve fiber layer thickness was positively correlated with the vessel density of the superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists in detecting early diabetic retinal pathological lesions.
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影响因子：
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作者：
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通讯作者：
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影响因子：
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2015-11-01
影响因子：
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