Department of Ophthalmology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Ann Med. 2022 Dec;54(1):1816-1825. doi: 10.1080/07853890.2022.2095010.
The characteristics of the early changes in preclinical diabetic retinopathy (DR) are poorly known. This study aimed to analyse the changes in the structure and function of the fundus in diabetic patients without diabetic retinopathy (NDR).
This prospective study enrolled patients with type 2 diabetes and healthy controls from April to December 2020. Retinal sensitivity was measured by microperimetry. The peripapillary retinal nerve fibre layer (p-RNFL) thickness, macular retinal thickness, and retinal volume were measured by optical coherence tomography (OCT). The vessel density (VD) and perfusion density (PD) of the peripapillary area, as well as the foveal avascular zone (FAZ) area, FAZ perimeter, and FAZ circularity, were measured by optical coherence tomographic angiography (OCTA).
A total of 71 cases (100 eyes) were enrolled in the study, including 34 cases (51 eyes) in the NDR group and 37 cases (49 eyes) in the control group. The mean retinal sensitivity was lower in the NDR group than in the control group for all sectors (all < .001). Compared with controls, the NDR group showed thinner p-RNFL in the T sector (76.24 ± 14.29 vs. 85.47 ± 19.66 µm, = .035). The NDR group had a thinner retina in the N2 sector (304.55 ± 16.07 vs. 312.02 ± 12.30 µm, = .010). The PD of DCP was lower in the N2 sector in the NDR group (44.92 ± 11.77 vs. 50.27 ± 6.37%, = .044). The VD was higher in the NDR group in RPCP-S/N/I, and the PD was higher in the RPCP-S/N (all < .05). The frequencies of perifoveal capillary drop-out, notched or punched out borders of the superficial FAZ, and loss of smooth contour were all higher in the NDR group (all < .05).
The structure (p-RNFL thickness, VD, and PD) and function (retinal sensitivity) display some changes in diabetic patients even if they had not been found to have DR.Key messagesDecreased retinal sensitivity was observed in diabetic patients before the onset of diabetic retinopathy.Compared with the control group, we found the changes in vessel density or perfusion density in a certain area, whether in SCP, DCP, or RPCP in the NDR group.Before the onset of diabetic retinopathy, the structure and function of the retina in diabetic patients had changed.
糖尿病视网膜病变（DR）的临床前期变化特点尚不清楚。本研究旨在分析无糖尿病视网膜病变（NDR）的糖尿病患者眼底结构和功能的变化。
本前瞻性研究纳入了 2020 年 4 月至 12 月期间的 2 型糖尿病患者和健康对照者。使用微视野计测量视网膜敏感度。通过光学相干断层扫描（OCT）测量视盘周围视网膜神经纤维层（p-RNFL）厚度、黄斑视网膜厚度和视网膜容积。通过光相干断层扫描血管造影术（OCTA）测量视盘周围区域的血管密度（VD）和灌注密度（PD）以及中心凹无血管区（FAZ）面积、FAZ 周长和 FAZ 圆度。
本研究共纳入了 71 例（100 只眼）患者，其中 NDR 组 34 例（51 只眼），对照组 37 例（49 只眼）。NDR 组各象限的视网膜敏感度均低于对照组（均<0.001）。与对照组相比，NDR 组 T 象限的 p-RNFL 较薄（76.24±14.29 比 85.47±19.66μm， = .035）。NDR 组 N2 象限的视网膜较薄（304.55±16.07 比 312.02±12.30μm， = .010）。NDR 组 N2 象限的 DCP 中 PD 较低（44.92±11.77 比 50.27±6.37%， = .044）。NDR 组在 RPCP-S/N/I 中 VD 较高，在 RPCP-S/N 中 PD 较高（均<0.05）。NDR 组出现周边毛细血管消失、浅层 FAZ 边界呈切迹或凿孔样改变以及轮廓光滑度丧失的频率均较高（均<0.05）。
在糖尿病视网膜病变发生之前，糖尿病患者的结构（p-RNFL 厚度、VD 和 PD）和功能（视网膜敏感度）已经发生了一些变化。
在糖尿病视网膜病变发生之前，糖尿病患者的视网膜已经发生了结构和功能的改变。
与对照组相比，我们发现 NDR 组在 SCP、DCP 或 RPCP 中某个区域的血管密度或灌注密度发生了变化。
在糖尿病视网膜病变发生之前，糖尿病患者的视网膜结构和功能已经发生了变化。
