Tayyari Faryan, Khuu Lee-Anne, Flanagan John G, Singer Shaun, Brent Michael H, Hudson Christopher
Retina Research Group, School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada.
Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Invest Ophthalmol Vis Sci. 2015 Oct;56(11):6796-800. doi: 10.1167/iovs.15-17481.
The aim of this study was to evaluate the relationship between retinal blood flow (RBF) and retinal blood oxygen saturation (SO2) in mild to moderate nonproliferative diabetic retinopathy (NPDR) and in age-matched controls.
One eye of each of 15 healthy subjects (68 ± 6 years) and 13 subjects with mild to moderate NPDR (67 ± 10 years) was dilated. None of the patients with NPDR had received treatment for their retinopathic changes or had any evidence of sight-threatening characteristics. Doppler Fourier-domain optical coherence tomography blood flow was measured using the prototype RTVue system; six separate measurements each comprising an upper and a lower nasal pupil scan were acquired. Six hyperspectral retinal measurements were acquired using a noninvasive hyperspectral retinal camera (prototype H-8.5 HR Camera).
Total RBF was significantly lower in NPDR when compared to controls (42.7 ± 7.5 vs. 33.0 ± 9.2 μL/min; P = 0.004). Mean retinal arterial and venular SO2 were higher in NPDR than in controls (94.7 ± 2.4% vs. 92.9 ± 1.6%, P = 0.02; 62.5 ± 5.7% vs. 56.3 ± 4.7%, P = 0.003). This study showed a correlation between RBF and arteriolar SO2 in both controls (r = 0.58, P = 0.02) and NPDR (r = 0.54, P = 0.05), but no correlation between venular RBF and venular SO2 in controls (r = 0.24, P = 0.83) or in NPDR (r = 0.23, P = 0.45). The arteriovenous difference (AV difference) was lower in the NPDR group when compared to controls (30.6 ± 6 vs. 36.7 ± 5.3, P = 0.008).
This study found a lower total RBF and a lower AV difference in the NPDR group, suggesting a reduced oxygen uptake from the retina in people with relatively early diabetic retinopathy.
本研究旨在评估轻度至中度非增殖性糖尿病视网膜病变(NPDR)患者及年龄匹配的对照组中视网膜血流(RBF)与视网膜血氧饱和度(SO2)之间的关系。
对15名健康受试者(68±6岁)和13名轻度至中度NPDR患者(67±10岁)的单眼进行散瞳。所有NPDR患者均未接受过针对视网膜病变的治疗,也没有任何威胁视力特征的证据。使用原型RTVue系统测量多普勒傅里叶域光学相干断层扫描血流;每次采集6次单独测量,每次测量包括一次上方和一次下方鼻侧瞳孔扫描。使用无创高光谱视网膜相机(原型H-8.5 HR相机)进行6次高光谱视网膜测量。
与对照组相比,NPDR患者的总RBF显著降低(42.7±7.5 vs. 33.0±9.2μL/min;P = 0.004)。NPDR患者的平均视网膜动脉和静脉SO2高于对照组(94.7±2.4% vs. 92.9±1.6%,P = 0.02;62.5±5.7% vs. 56.3±4.7%,P = 0.003)。本研究表明,对照组(r = 0.58,P = 0.02)和NPDR组(r = 0.54,P = 0.05)中RBF与小动脉SO2之间存在相关性,但对照组(r = 0.24,P = 0.83)或NPDR组(r = 0.23,P = 0.45)中静脉RBF与静脉SO2之间无相关性。与对照组相比,NPDR组的动静脉差值(AV差值)更低(30.6±6 vs. 36.7±5.3,P = 0.008)。
本研究发现NPDR组的总RBF和AV差值更低,提示相对早期糖尿病视网膜病变患者视网膜的氧摄取减少。