Sidorczuk Patryk, Obuchowska Iwona, Konopinska Joanna, Dmuchowska Diana A
Ophthalmology Department, Medical University of Bialystok, 24a M. Sklodowskiej-Curie, 15-276 Bialystok, Poland.
J Clin Med. 2022 Jul 4;11(13):3882. doi: 10.3390/jcm11133882.
The choroid supplies blood to the outer retina. We quantified outer retinal and choroidal parameters to understand better the pathogenesis of diabetic retinopathy (DR) and diabetic macular edema (DME). The retrospective cross-sectional single-center study included 210 eyes from 139 diabetic patients and 76 eyes from 52 healthy controls. Spectral-domain optical coherence tomography (OCT) was carried out with a Spectralis HRA + OCT imaging device. The outer retinal layer (ORL), outer nuclear layer (ONL), and choroidal thicknesses were assessed along with the choroidal vascularity index (CVI). The presence of DR, whether with DME or without, was associated with choroidal thinning (p < 0.001). Compared with the controls, patients with DR without DME presented with lower ORL and ONL thickness (p < 0.001), whereas those with DR and DME had higher values of both parameters (p < 0.001). Significant correlations between outer retinal and choroidal parameters were found only in patients with DR without DME (ORL with choroidal thickness: p = 0.003, rho = 0.34; ORL with CVI: p < 0.001, rho = 0.49, ONL with CVI: p < 0.027, rho = 0.25). No correlations between choroidal and outer retinal parameters were observed in the controls and patients with DR and concomitant DME. Aside from diabetic choroidopathy, other pathogenic mechanisms seem to predominate in the latter group.
脉络膜为视网膜外层供血。我们对视网膜外层和脉络膜参数进行量化,以更好地了解糖尿病视网膜病变(DR)和糖尿病性黄斑水肿(DME)的发病机制。这项回顾性横断面单中心研究纳入了139例糖尿病患者的210只眼以及52例健康对照者的76只眼。使用Spectralis HRA + OCT成像设备进行了光谱域光学相干断层扫描(OCT)。评估了视网膜外层(ORL)、外核层(ONL)和脉络膜厚度以及脉络膜血管指数(CVI)。DR的存在,无论是否伴有DME,均与脉络膜变薄相关(p < 0.001)。与对照组相比,无DME的DR患者的ORL和ONL厚度较低(p < 0.001),而伴有DME的DR患者这两个参数的值较高(p < 0.001)。仅在无DME的DR患者中发现视网膜外层和脉络膜参数之间存在显著相关性(ORL与脉络膜厚度:p = 0.003,rho = 0.34;ORL与CVI:p < 0.001,rho = 0.49,ONL与CVI:p < 0.027,rho = 0.25)。在对照组以及伴有DME的DR患者中未观察到脉络膜与视网膜外层参数之间的相关性。除糖尿病脉络膜病变外,其他致病机制似乎在后者中占主导地位。