Kim Mirinae, Kim Rae-Young, Park Wookyung, Park Young-Gun, Kim In-Beom, Park Young-Hoon
Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Catholic Institute for Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Acta Ophthalmol. 2020 Nov;98(7):e807-e813. doi: 10.1111/aos.14421. Epub 2020 Apr 4.
To assess whether functional (electrophysiological) parameters are related to changes in the structural (microvascular) parameters in diabetic retina.
This prospective cohort study included 380 eyes of patients with diabetes mellitus (DM) and 160 eyes of healthy controls. We analysed the electroretinogram (ERG) parameters and vascular parameters acquired from optical coherence tomography (OCT) angiography according to the diabetic retinopathy (DR) severity from early to late stages of DR.
After exclusion, 366 eyes of diabetes and 157 eyes of controls were included in the analysis. The mean age at enrolment was 65.4 ± 7.8 years, and 177 (33.84%) were male. The amplitude and implicit time of the rod and cone and combined response ERG b-wave were significantly reduced and prolonged in the eyes of patients with DM, compared to the controls. There was a positive correlation between the amplitude and vessel density (VD) of the superficial plexus and a negative correlation between the implicit time and superficial VD in the scotopic and combined response b-wave. Interestingly, there was no correlation between electrophysiological parameters and deep VD. These correlations between electrophysiological parameters and vascular parameters were not significant in the non-diabetic, healthy control group.
Functional and structural impairments precede the clinical manifestation of DR. We also found that these neural impairments, evaluated by ERG, were correlated with superficial VD. However, this correlation was absent in the healthy and early DR groups. These findings carefully suggest that neuronal dysfunction is linked to vascular dysfunction in type 2 diabetes.
评估糖尿病视网膜病变中功能（电生理）参数是否与结构（微血管）参数的变化相关。
这项前瞻性队列研究纳入了380例糖尿病患者的眼睛和160例健康对照者的眼睛。我们根据糖尿病视网膜病变（DR）从早期到晚期的严重程度，分析了从光学相干断层扫描（OCT）血管造影获得的视网膜电图（ERG）参数和血管参数。
排除后，分析纳入了366只糖尿病患者的眼睛和157只对照者的眼睛。入组时的平均年龄为65.4±7.8岁，男性177例（33.84%）。与对照组相比，糖尿病患者眼睛中视杆和视锥以及联合反应ERG b波的振幅和隐含时间显著降低和延长。暗视和联合反应b波中，浅层神经丛的振幅与血管密度（VD）呈正相关，隐含时间与浅层VD呈负相关。有趣的是，电生理参数与深层VD之间没有相关性。在非糖尿病健康对照组中，电生理参数与血管参数之间的这些相关性不显著。
功能和结构损伤先于DR的临床表现出现。我们还发现，通过ERG评估的这些神经损伤与浅层VD相关。然而，在健康组和早期DR组中不存在这种相关性。这些发现谨慎地表明，2型糖尿病中的神经元功能障碍与血管功能障碍有关。
