Ahmadzadeh Amiri Ali, Sheikh Rezaee Majid Reza, Ahmadzadeh Amiri Amir, Soleymanian Tayebeh, Jafari Reza, Ahmadzadeh Amiri Ahmad
Tehran University of Medical Sciences, Tehran, Iran.
Department of Ophthalmology, Bu Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Ophthalmol Ther. 2020 Mar;9(1):139-148. doi: 10.1007/s40123-020-00236-y. Epub 2020 Feb 19.
Diabetic macular ischemia (DMI) is an important category of diabetic retinopathy (DR) which leads to severe visual loss. Clinically, it is defined by an enlargement of the foveal avascular zone (FAZ) that can be detected by optical coherence tomography angiography (OCTA). Studies have described a relationship between renal disease and these changes in FAZ area. The aim of this study was to compare disturbances in FAZ area in diabetic patients with or without overt nephropathy.
Following approval of the ethics committee, we examined diabetic patients with retinopathy. Patients were divided into two groups of DR, namely, with overt nephropathy and without overt nephropathy. The FAZ area was measured using OCTA. A P value of < 0.05 was considered to be statistically significant.
A total of 46 patients (78 eyes) were enrolled in this study. All eyes with DR showed significant changes in FAZ area, but the sizes of the FAZ area were larger in both the superficial and deep layers in patients with clinical albuminuria than in those with no microalbuminuria (P = 0.007 and P = 0.002, respectively).
These results demonstrate that OCTA provides highly detailed information on retinal microvasculature and that it is a reliable modality to assess DR progression in patients with nephropathy. They also show that renal impairment as a systemic risk factor was associated with enlarged FAZ area in DM.
糖尿病性黄斑缺血（DMI）是糖尿病视网膜病变（DR）的一个重要类型，可导致严重视力丧失。临床上，它通过光学相干断层扫描血管造影（OCTA）检测到的黄斑无血管区（FAZ）扩大来定义。研究描述了肾脏疾病与FAZ面积这些变化之间的关系。本研究的目的是比较有或无显性肾病的糖尿病患者FAZ面积的差异。
经伦理委员会批准后，我们对患有视网膜病变的糖尿病患者进行了检查。患者被分为两组DR，即有显性肾病组和无显性肾病组。使用OCTA测量FAZ面积。P值<0.05被认为具有统计学意义。
本研究共纳入46例患者（78只眼）。所有DR患者的眼睛FAZ面积均有显著变化，但临床白蛋白尿患者的FAZ面积在浅层和深层均大于无微白蛋白尿患者（分别为P = 0.007和P = 0.002）。
这些结果表明，OCTA可提供有关视网膜微血管系统的高度详细信息，并且是评估肾病患者DR进展的可靠方法。它们还表明，作为全身危险因素的肾功能损害与糖尿病患者FAZ面积增大有关。
