Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Microcirculation. 2010 May;17(4):297-302. doi: 10.1111/j.1549-8719.2010.00021.x.
Retinal vascular caliber changes predict diabetic microvascular complications such as retinopathy, and nephropathy. However, the association between retinal vasculature and peripheral neuropathy is not well studied.
We evaluated the association between retinal vascular caliber and peripheral neuropathy in a multi-ethnic Asian population with diabetes (n = 423) in Singapore. Retinal arteriolar and venular caliber was measured from digital retinal photographs and summarized as central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent. Peripheral neuropathy was defined from neurothesiometer or monofilament sensory testing.
Larger CRAE was positively associated with peripheral neuropathy independent of age, sex, ethnicity, current smoking, alcohol consumption, body mass index, total cholesterol, systolic blood pressure, and duration of diabetes. The multivariable odds ratio (OR) [95% confidence interval (CI)] of peripheral neuropathy was 2.81 (1.38-5.73) comparing highest vs. lower three quartiles of CRAE. This association was consistently present in analyses stratified by age, sex and ethnicity. Retinal venular caliber was not associated with peripheral neuropathy.
These data suggest that larger retinal arteriolar diameters are associated with peripheral neuropathy independent of major risk factors.
视网膜血管口径的变化可预测糖尿病微血管并发症，如视网膜病变和肾病。然而，视网膜血管与周围神经病变之间的关联尚未得到充分研究。
我们在新加坡的一个多民族亚洲糖尿病患者（n=423）人群中评估了视网膜血管口径与周围神经病变之间的关系。从数字视网膜照片中测量视网膜小动脉和小静脉的口径，并总结为中心视网膜小动脉当量（CRAE）和中心视网膜小静脉当量。周围神经病变通过神经感觉计或单丝感觉测试来定义。
较大的 CRAE 与外周神经病变独立于年龄、性别、种族、当前吸烟、饮酒、体重指数、总胆固醇、收缩压和糖尿病病程有关。最高四分位与最低三分位 CRAE 相比，外周神经病变的多变量比值比（OR）[95%置信区间（CI）]为 2.81（1.38-5.73）。这种关联在按年龄、性别和种族分层的分析中始终存在。视网膜小静脉口径与周围神经病变无关。
这些数据表明，较大的视网膜小动脉直径与周围神经病变有关，而与主要危险因素无关。
