Retinal ganglion cell neuronal damage in diabetes and diabetic retinopathy
Retinal ganglion cell neuronal damage in diabetes and diabetic retinopathy
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DOI：
10.1111/ceo.12724
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发表时间：
2016-05-01
影响因子：
4
通讯作者：
Ikram, Mohammad K.
中科院分区：
文献类型：
--
作者：
Ng, Dorothy S. K.;Chiang, Peggy P. C.;Ikram, Mohammad K.
背景检查糖尿病和糖尿病性视网膜病变（DR）与视网膜神经节细胞（RGC）损失的关联。设计观察性病例对照研究。参与者为2型糖尿病病例和年龄性别匹配的无糖尿病对照。方法在自动分割黄斑后计算RGC的谱域光学相干断层扫描（OCT）参数 扫描。使用改良的艾尔利屋分类系统根据眼底照片对 DR 严重程度进行分级。使用广义估计方程来比较病例和对照之间的 OCT 参数，并调整协变量。主要结果测量平均神经节细胞内丛状层 (GC-IPL) 和平均视网膜神经纤维层 (RNFL) 厚度。结果我们分析了 227 例病例和 227 名对照。病例的平均年龄（岁）为 58.3 岁，对照组为 58.1 岁（P=0.13）。在病例中，101 例没有，25 例为轻度，101 例为中度或重度 DR。与对照组相比，所有病例中 GC-IPL 和 RNFL 均较薄 [平均差（95% 置信区间 [CI]）：GC-IPL -4.49 μ m (-2.92; -6.06)、RNFL -0.93 μ m (-0.09; -1.85)]，包括无 DR 的病例 [平均差 (95% CI)、GC-IPL -4.37 μ m (-2.72; -1.85)]。 -6.02)，RNFL -1.06μm(-0.10；-2.02)]。患有任何 DR 的病例的 GC-IPL 比对照组薄 [平均差异 (95% CI)：GC-IPL -4.81 μ m (-2.12; -7.50)]。在病例中，患有中度或重度 DR 的受试者的 GC-IPL 较无 DR 的受试者要薄 [平均差异 (95% CI)：GC-IPL -2.07 μ m (-0.08; -4.07)]。 结论 患有糖尿病且无 DR 的受试者中存在 RGC 损失，并且在中度或重度 DR 中呈进展性。临床上可以使用 OCT 检测糖尿病和 DR 中的 RGC 神经元损伤。
BackgroundTo examine the association of diabetes and diabetic retinopathy (DR) with retinal ganglion cell (RGC) loss.DesignObservational case-control study.ParticipantsType 2 diabetes cases and age-gender matched controls without diabetes.MethodsSpectral-domain optical coherence tomography (OCT) parameters of RGCs were calculated after automated segmentation of macular scans. DR severity was graded on fundus photographs using the modified Airlie House Classification system. Generalized estimating equation was used to compare OCT parameters between cases and controls, adjusted for covariates.Main Outcome MeasuresAverage ganglion cell-inner plexiform layer (GC-IPL) and average retinal nerve fibre layer (RNFL) thicknesses.ResultsWe analyzed 227 cases and 227 controls. The mean age (years) of cases was 58.3 and controls was 58.1 (P=0.13). Among cases, 101 had none, 25 had mild and 101 had moderate or severe DR. Compared with controls, GC-IPL and RNFL were thinner in all cases [mean difference (95% confidence interval [CI]): GC-IPL -4.49 mu m (-2.92; -6.06), RNFL -0.93 mu m (-0.09; -1.85)], including cases with no DR [mean difference (95% CI), GC-IPL -4.37 mu m (-2.72; -6.02), RNFL -1.06 mu m (-0.10; -2.02)]. Cases with any DR had thinner GC-IPL than controls [mean difference (95% CI): GC-IPL -4.81 mu m (-2.12; -7.50)]. Among cases, subjects with moderate or severe DR had thinner GC-IPL than subjects with no DR [mean difference (95% CI): GC-IPL -2.07 mu m (-0.08; -4.07)].ConclusionsRGC loss is present in subjects with diabetes and no DR, and is progressive in moderate or severe DR. RGC neuronal damage in diabetes and DR can be clinically detected using OCT.