1型糖尿病且无糖尿病视网膜病变或仅有早期症状患者的视网膜单一层面评估：神经元与毛细血管之间神经血管串扰损伤的首个迹象？
Single Retinal Layer Evaluation in Patients with Type 1 Diabetes with No or Early Signs of Diabetic Retinopathy: The First Hint of Neurovascular Crosstalk Damage between Neurons and Capillaries?
作者信息
Scarinci Fabio, Picconi Fabiana, Virgili Gianni, Giorno Paola, Di Renzo Antonio, Varano Monica, Frontoni Simona, Parravano Mariacristina
机构信息
Department of Ophthalmology, G.B. Bietti Eye Foundation-IRCCS, Rome, Italy.
出版信息
Ophthalmologica. 2017;237(4):223-231. doi: 10.1159/000453551. Epub 2017 Apr 8.
PURPOSE
To analyze the retinal-choroidal changes in type 1 diabetes mellitus (DM1) patients with no or early signs of diabetic retinopathy (DR).
METHODS
Seventy-six eyes of 38 DM1 patients and 26 control eyes were included. Nine individual retinal layer thickness measurements were obtained using the spectral domain-optical coherence tomography automated segmentation algorithm.
RESULTS
The retinal nerve fiber layer was slightly thinner in all explored quadrants, even if the reduction was not significant in DM1 eyes versus control eyes. The inner nuclear layer (INL) thickness was thicker in all DM1 eyes versus control eyes in all quadrants (p < 0.050). Analyses adjusting for inner retinal thickness in all sectors confirmed INL thickening by about 4%, and also found a significant thinning of the ganglion cell layer (GCL) by about 3.5% in all DM1 subjects versus controls (p < 0.050).
CONCLUSION
DM1 patients with no or early signs of DR present retinal changes particularly at the INL and GCL that might be correlated to initial findings of neurodegeneration.
目的
分析无糖尿病视网膜病变（DR）或仅有DR早期迹象的1型糖尿病（DM1）患者的视网膜 - 脉络膜变化。
方法
纳入38例DM1患者的76只眼和26只对照眼。使用光谱域光学相干断层扫描自动分割算法获得9个个体视网膜层厚度测量值。
结果
在所有探测象限中，视网膜神经纤维层均稍薄，尽管DM1眼与对照眼相比减少不显著。在所有象限中，所有DM1眼的内核层（INL）厚度均比对照眼厚（p < 0.050）。对所有扇区内视网膜厚度进行校正的分析证实INL增厚约4%，并且还发现所有DM1受试者的神经节细胞层（GCL）比对照组显著变薄约3.5%（p < 0.050）。
结论
无DR或仅有DR早期迹象的DM1患者存在视网膜变化，特别是在内核层和神经节细胞层，这可能与神经退行性变的初始发现相关。
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