Srinivasan Sangeetha, Pritchard Nicola, Vagenas Dimitrios, Edwards Katie, Sampson Geoff P, Russell Anthony W, Malik Rayaz A, Efron Nathan
a Institute of Health and Biomedical Innovation , Queensland University of Technology , Queensland , Australia.
b Princess Alexandra Hospital , Queensland , Australia.
Curr Eye Res. 2016 Oct;41(10):1359-1366. doi: 10.3109/02713683.2015.1119855. Epub 2016 Feb 29.
To investigate the relationship between diabetic peripheral neuropathy (DPN) and retinal tissue thickness.
Full retinal thickness in the central retinal, parafoveal, and perifoveal zones and thickness of the ganglion cell complex and retinal nerve fiber layer (RNFL) were assessed in 193 individuals (84 with type 1 diabetes, 67 with type 2 diabetes, and 42 healthy controls) using spectral domain optical coherence tomography. Among those with diabetes, 44 had neuropathy defined using a modified neuropathy disability score recorded on a 0-10 scale. Multiple regression analysis was performed to investigate the relationship between diabetic neuropathy and retinal tissue thickness, adjusted for the presence of diabetic retinopathy (DR), age, sex, duration of diabetes, and HbA levels.
In individuals with diabetes, perifoveal thickness was inversely related to the severity of neuropathy (p < 0.05), when adjusted for age, sex, duration of diabetes, and HbA levels. DR was associated with reduced thickness in parafovea (p < 0.01). The RNFL was thinner in individuals with greater degrees of neuropathy (p < 0.04).
DPN is associated with structural compromise involving several retinal layers. This compromise may represent a threat to visual integrity and therefore warrants examination of functional correlates.
研究糖尿病周围神经病变(DPN)与视网膜组织厚度之间的关系。
使用光谱域光学相干断层扫描技术,对193名个体(84例1型糖尿病患者、67例2型糖尿病患者和42名健康对照者)的视网膜中央区、黄斑旁区和黄斑周围区的全视网膜厚度以及神经节细胞复合体和视网膜神经纤维层(RNFL)的厚度进行评估。在糖尿病患者中,44例根据改良的神经病变残疾评分(范围为0至10分)被定义为患有神经病变。进行多元回归分析,以研究糖尿病神经病变与视网膜组织厚度之间的关系,并对糖尿病视网膜病变(DR)的存在、年龄、性别、糖尿病病程和糖化血红蛋白(HbA)水平进行校正。
在糖尿病患者中,校正年龄、性别、糖尿病病程和HbA水平后,黄斑周围厚度与神经病变严重程度呈负相关(p<0.05)。DR与黄斑旁区厚度降低相关(p<0.01)。神经病变程度较高的个体中RNFL较薄(p<0.04)。
DPN与涉及多个视网膜层的结构损害相关。这种损害可能对视功能完整性构成威胁,因此有必要检查其功能相关性。