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应用扫频源光学相干断层扫描观察未经治疗的糖尿病患者眼肾功与视盘周围脉络膜厚度的相关性。

Correlation between Renal Function and Peripapillary Choroidal Thickness in Treatment-Naïve Diabetic Eyes Using Swept-Source Optical Coherence Tomography.

机构信息

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.

出版信息

Curr Eye Res. 2020 Dec;45(12):1526-1533. doi: 10.1080/02713683.2020.1753213. Epub 2020 Apr 20.

DOI:10.1080/02713683.2020.1753213
PMID:32255371
Abstract

: 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.

摘要

: 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。

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