Department of Nephrology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
Department of Nephrology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
Invest Ophthalmol Vis Sci. 2020 Dec 1;61(14):14. doi: 10.1167/iovs.61.14.14.
We sought to assess the relationship between retinal nonperfusion area (NPA) on ultra-widefield fluorescein angiography (UWFA) and renal function in type 2 diabetes mellitus (DM) patients with diabetic retinopathy (DR) and nephropathy.
UWFA was performed in 248 eyes (124 patients) with DR, comprising 94 eyes from patients with chronic kidney disease (CKD) caused by diabetes and 154 eyes without CKD (non-CKD). Serum creatinine level (Cr), estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio (UACR), and urine protein/creatinine ratio (UPCR) were collected. On UWFA, retinal NPA was measured in an automated manner. The correlation between NPA and renal function was analyzed.
The mean NPA value of the total eye was 33.11 ± 45.77-disc diameter (DA) in non-CKD and 100.57 ± 69.52 in CKD (P < 0.001). NPA of posterior pole was 1.21 ± 3.28 DA in non-CKD and 7.99 ± 6.75 in CKD group (P < 0.001). The NPA values of both the total eye and posterior pole were significantly correlated with Cr (r = 0.585 and 0.483), eGFR (r = -0.572 and -0.524), UACR (r = 0.541 and 0.482), and UPCR (r = 0.509 and 0.529, respectively) (all P ≤ 0.001). Linear modeling encompassing all clinical factors and relative clinical factors suggested eGFR as the most important predictor for NPAs of the total eye and posterior pole.
Larger retinal NPA on UWFA is associated with worse renal function in DM patients. Renal function can be used to predict retinal NPA in type 2 DM patients with nephropathy and DR.
我们旨在评估 2 型糖尿病（DM）伴糖尿病视网膜病变（DR）和肾病患者超广角荧光素血管造影（UWFA）上视网膜无灌注区（NPA）与肾功能之间的关系。
对 248 只眼（124 例患者）进行 UWFA 检查，包括 94 只由糖尿病引起的慢性肾脏病（CKD）患者的眼和 154 只无 CKD（非 CKD）的眼。收集血清肌酐水平（Cr）、估算肾小球滤过率（eGFR）、尿白蛋白/肌酐比（UACR）和尿蛋白/肌酐比（UPCR）。在 UWFA 上，自动测量视网膜 NPA。分析 NPA 与肾功能之间的相关性。
非 CKD 组总眼 NPA 值的平均值为 33.11±45.77 视盘直径（DA），CKD 组为 100.57±69.52（P<0.001）。非 CKD 组后极 NPA 为 1.21±3.28 DA，CKD 组为 7.99±6.75（P<0.001）。总眼和后极的 NPA 值与 Cr（r=0.585 和 0.483）、eGFR（r=-0.572 和-0.524）、UACR（r=0.541 和 0.482）和 UPCR（r=0.509 和 0.529）显著相关（均 P≤0.001）。包含所有临床因素和相对临床因素的线性模型表明，eGFR 是总眼和后极 NPA 的最重要预测因子。
UWFA 上较大的视网膜 NPA 与 DM 患者的肾功能较差相关。肾功能可用于预测 2 型 DM 伴肾病和 DR 患者的视网膜 NPA。
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