Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangzhou, People's Republic of China.
Jinan University Affiliated Shenzhen Eye Hospital, Guangzhou, People's Republic of China.
Invest Ophthalmol Vis Sci. 2022 Feb 1;63(2):7. doi: 10.1167/iovs.63.2.7.
To evaluate the role of the peripapillary retinal nerve fiber layer (pRNFL) and peripapillary choroidal thickness (pCT) in the development and progression of diabetic retinopathy (DR).
This is a cohort study based on the baseline and 2-year follow-up data of the Guangzhou Diabetic Eye Study. Patients with type 2 diabetes mellitus between the ages of 30 and 80 years were recruited from communities in Guangzhou. DR was graded by seven-field fundus photography after dilation of the pupil. pRNFL and pCT were measured via swept-source optical coherence tomography.
A total of 895 patients were included in the study; of these, 748 did not have DR at baseline and 147 had DR at baseline. During the 2-year follow-up, 80 developed DR (10.7%), and 11 experienced DR progression (7.5%). After adjusting for confounding factors, a higher risk of incident DR was strongly associated with a lower average thickness of the pRNFL (risk ratio [RR] per 1 SD, 0.55; 95% confidence interval [CI], 0.42-0.72; P < 0.001) and average pCT (RR per 1 SD, 0.49; 95% CI, 0.34-0.70; P < 0.001). Adding both metrics to the DR prediction model significantly improved the discriminant ability of the model for incidences of DR (area under the curve increased by 15.38% from 0.673 to 0.777; P < 0.001).
Neurodegeneration shown by the thinning of pRNFL and impaired choroidal circulation shown by the thinning of pCT are independently associated with DR onset, and assessing both metrics can improve the risk assessment for DR incidences.
评估视盘周围视网膜神经纤维层（pRNFL）和视盘周围脉络膜厚度（pCT）在糖尿病视网膜病变（DR）发展和进展中的作用。
这是一项基于广州糖尿病眼病研究的基线和 2 年随访数据的队列研究。从广州社区招募年龄在 30 至 80 岁之间的 2 型糖尿病患者。通过瞳孔扩张后的 7 视野眼底照相对 DR 进行分级。通过扫频源光学相干断层扫描测量 pRNFL 和 pCT。
共有 895 例患者纳入研究；其中，748 例患者基线时无 DR，147 例患者基线时患有 DR。在 2 年的随访期间，有 80 例患者发生 DR（10.7%），11 例患者出现 DR 进展（7.5%）。在调整混杂因素后，pRNFL 平均厚度降低（每 1 SD 的风险比[RR]，0.55；95%置信区间[CI]，0.42-0.72；P<0.001）和平均 pCT（每 1 SD 的 RR，0.49；95% CI，0.34-0.70；P<0.001）与新发 DR 的风险呈强烈相关。将这两个指标加入到 DR 预测模型中，显著提高了模型对 DR 发生率的判别能力（曲线下面积从 0.673 增加到 0.777，增加了 15.38%；P<0.001）。
pRNFL 变薄提示神经退行性变，pCT 变薄提示脉络膜循环受损，这两者均与 DR 发病独立相关，评估这两个指标可以提高 DR 发生率的风险评估。
