Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University , Guangzhou, People's Republic of China.
School of Medicine, Sun Yat-sen University Guangzhou , China.
Curr Eye Res. 2020 Dec;45(12):1526-1533. doi: 10.1080/02713683.2020.1753213. Epub 2020 Apr 20.
: To investigate the associations of the estimated glomerular filtration rate (eGFR) with peripapillary choroidal thickness (pCT) and retinal nerve fiber layer (pRNFL) thickness in diabetic patients by using swept-source optical coherence tomography (SS-OCT). : Ocular treatment-naïve patients with type 2 diabetes mellitus registered in the community health system in Guangzhou, China, were recruited to participate in this prospective cross-sectional study. The eGFR was determined using the Xiangya formula, and the renal function was categorized into non-chronic kidney disease (non-CKD), mild CKD, and moderate to severe CKD (MS-CKD) according to the guidelines. The pCT and pRNFL thicknesses at 12 o'clock were obtained using an SS-OCT by a circular scan with a diameter of 3.4 mm centering on the optic nerve head, and the data from only one eye in each patient were used. : This study included 1,408 diabetic patients, with a mean age of 64.4 ± 7.8 years. The average pCT decreased with renal function deterioration, with 126.0 ± 58.0 μm for non-CKD, 112.0 ± 51.2 μm for mild CKD and 71.0 ± 22.9 μm for MS-CKD, respectively ( < .001). The pCT was found to be significantly thinner in CKD patients in all quadrantes ( < .05 in all regions) with the exception of the inferior quadrant, and the average pCT was positively correlated with eGFR (β = 0.3, 95%CI = 0.0 to 0.6, = .021) after adjusting for other factors. The pRNFL thickness in the nasal quadrant was significantly reduced in patients with CKD, and pRNFL thickness was positively correlated with eGFR (β = 0.1, 95%CI = 0.0-0.2, = .009) after adjusting for other factors. : Impaired renal function was associated with a reduction of pCT and pRNFL thickness in patients with type 2 diabetes. The measurement of pCT and pRNFL may provide additional information for predicting renal impairment.
: 本研究采用扫频源光学相干断层扫描(SS-OCT)观察估计肾小球滤过率(eGFR)与糖尿病患者的视盘周围脉络膜厚度(pCT)和视网膜神经纤维层(pRNFL)厚度之间的相关性。 : 在中国广州社区卫生系统登记的未经眼部治疗的 2 型糖尿病患者被招募参与这项前瞻性横断面研究。采用湘雅公式计算 eGFR,并根据指南将肾功能分为非慢性肾脏病(non-CKD)、轻度 CKD 和中重度 CKD(MS-CKD)。使用 SS-OCT 通过以视盘为中心的直径 3.4mm 的圆形扫描获取 12 点钟处的 pCT 和 pRNFL 厚度,每个患者仅使用一只眼的数据。 : 本研究共纳入 1408 例糖尿病患者,平均年龄 64.4±7.8 岁。随着肾功能恶化,平均 pCT 逐渐降低,非 CKD 组为 126.0±58.0μm,轻度 CKD 组为 112.0±51.2μm,中重度 CKD 组为 71.0±22.9μm(<0.001)。在所有象限中,CKD 患者的 pCT 均明显变薄(所有区域均<0.05),除下象限外,平均 pCT 与 eGFR 呈正相关(β=0.3,95%CI=0.0 至 0.6,=0.021),在调整其他因素后。在调整其他因素后,CKD 患者的鼻侧象限 pRNFL 厚度明显降低,pRNFL 厚度与 eGFR 呈正相关(β=0.1,95%CI=0.0 至 0.2,=0.009)。 : 肾功能受损与 2 型糖尿病患者的 pCT 和 pRNFL 厚度降低有关。pCT 和 pRNFL 的测量可能为预测肾功能损害提供额外信息。