Department of Ophthalmology, King George's Medical University, Lucknow, India.
Department of Pathology, King George's Medical University, Lucknow, India.
Int Ophthalmol. 2021 Nov;41(11):3623-3630. doi: 10.1007/s10792-021-01941-8. Epub 2021 Jun 29.
Cortisol, a steroid hormone, plays an essential role in metabolic processes of diabetes mellitus. This study for the first time evaluated the association of serum cortisol with spectral domain optical coherence tomography (SD-OCT)-based cross-sectional and topographic parameters with severity of diabetic retinopathy (DR).
A tertiary care center-based preliminary study was undertaken. Fourteen consecutive cases of DR and fifteen healthy controls were included. Cases were graded according to ETDRS classification: non-proliferative DR (NPDR, n = 8) and proliferative DR (PDR, n = 6). All study subjects underwent complete ophthalmological evaluation. Serum cortisol was analyzed using chemiluminescence microparticle assay method. Central subfield thickness (CST), cube average thickness (CAT), cube volume (CV), retinal nerve fiber layer (RNFL) thickness, disorganization of inner retinal layers (DRIL), grade of retinal photoreceptor ellipsoid zone (EZ) disruption and grade of retinal pigment epithelium (RPE) alterations were evaluated using SD-OCT. Statistical analysis was done using ANOVA and Pearson's correlation analysis.
Mean serum cortisol levels (µg/dL) were NPDR = 11.59 ± 0.42, PDR = 14.50 ± 0.26 and controls = 8.22 ± 0.77. With increasing severity of DR, mean CST, CAT, CV showed positive correlation, whereas mean RNFL thickness showed negative correlation with serum cortisol levels (p < 0.01). DRIL, EZ disruption and RPE alterations showed positive correlation with serum cortisol levels (p < 0.001).
Serum cortisol levels are significantly associated with severity of DR and correlate positively with CST, CAT, CV, DRIL, EZ disruption and RPE alterations and negatively with RNFL thickness.
皮质醇是一种类固醇激素，在糖尿病的代谢过程中发挥着重要作用。本研究首次评估了血清皮质醇与基于谱域光相干断层扫描（SD-OCT）的横断面和地形参数与糖尿病视网膜病变（DR）严重程度的相关性。
进行了一项三级保健中心的初步研究。纳入了 14 例连续的 DR 病例和 15 例健康对照者。根据 ETDRS 分类对病例进行分级：非增生性糖尿病视网膜病变（NPDR，n=8）和增生性糖尿病视网膜病变（PDR，n=6）。所有研究对象均接受了全面的眼科评估。使用化学发光微粒子测定法分析血清皮质醇。使用 SD-OCT 评估中央视网膜神经纤维层（RNFL）厚度、中心视网膜厚度（CST）、立方平均厚度（CAT）、立方体积（CV）、视网膜内组织紊乱（DRIL）、视网膜感光细胞椭圆体带（EZ）破坏程度和视网膜色素上皮（RPE）改变程度。使用方差分析和 Pearson 相关分析进行统计学分析。
NPDR 的平均血清皮质醇水平（µg/dL）为 11.59±0.42，PDR 为 14.50±0.26，对照组为 8.22±0.77。随着 DR 严重程度的增加，平均 CST、CAT、CV 呈正相关，而平均 RNFL 厚度与血清皮质醇水平呈负相关（p<0.01）。DRIL、EZ 破坏和 RPE 改变与血清皮质醇水平呈正相关（p<0.001）。
血清皮质醇水平与 DR 的严重程度显著相关，与 CST、CAT、CV、DRIL、EZ 破坏和 RPE 改变呈正相关，与 RNFL 厚度呈负相关。
