da Silva Monica Oliveira, do Carmo Chaves Anne Elise Cruz, Gobbato Glauber Corrêa, Dos Reis Mateus Augusto, Lavinsky Fabio, Schaan Beatriz D'Agord, Lavinsky Daniel
Retina and Vitreous Research Center, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
Graduate Program in Endocrinology, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
Int J Retina Vitreous. 2021 Dec 5;7(1):73. doi: 10.1186/s40942-021-00347-z.
To evaluate retinal thickness and capillary density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT).
A cross-sectional study was conducted with T2D patients with mild or no diabetic retinopathy (DR) and nondiabetic controls. Inner retinal layer thickness was measured with SS-OCT. Retinal capillary density and the foveal avascular zone (FAZ) were measured with SS-OCT angiography (OCTA). SS-OCT parameters were compared in patients with and without diabetic kidney disease (DKD) and nondiabetic controls.
131 DKD eyes showed decreased ganglion cell layer plus (GCL+) (p = 0.005 TI; p = 0.022 I), retinal nerve fiber layer (RNFL) (p = 0.003), and central retinal thickness (CRT) (p = 0.032), as well as foveal avascular zone (FAZ) enlargement (p = 0.003) and lower capillary density in the superficial vascular plexus (p = 0.016, central quadrant), compared to controls. No statistically significant changes were found between diabetic patients without significant DKD and controls.
Our findings suggest early neurovascular damage in patients with T2D; these changes were more significant in patients with DKD. Larger longitudinal studies are warranted to determine the role of early neurovascular damage in the pathophysiology of severe DR.
使用扫频光学相干断层扫描（SS-OCT）评估2型糖尿病（T2D）患者的视网膜厚度和毛细血管密度及其与糖尿病肾病（DKD）的关联。
对患有轻度或无糖尿病视网膜病变（DR）的T2D患者和非糖尿病对照者进行横断面研究。用SS-OCT测量视网膜内层厚度。用SS-OCT血管造影（OCTA）测量视网膜毛细血管密度和黄斑无血管区（FAZ）。比较有和没有糖尿病肾病（DKD）的患者以及非糖尿病对照者的SS-OCT参数。
与对照组相比，131只DKD眼睛的神经节细胞层加（GCL+）（p = 0.005 TI；p = 0.022 I）、视网膜神经纤维层（RNFL）（p = 0.003）和中央视网膜厚度（CRT）（p = 0.032）降低，以及黄斑无血管区（FAZ）扩大（p = 0.003）和浅层血管丛中的毛细血管密度降低（p = 0.016，中央象限）。在没有明显DKD的糖尿病患者和对照组之间未发现统计学上的显著变化。
我们的研究结果表明T2D患者存在早期神经血管损伤；这些变化在DKD患者中更为显著。需要进行更大规模的纵向研究来确定早期神经血管损伤在严重DR病理生理学中的作用。
