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肾功能与增殖性糖尿病视网膜病变患者手术结果的关系。

The relationship between renal function and surgical outcomes of patients with proliferative diabetic retinopathy.

机构信息

Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Ophthalmology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Aug 25;13:984561. doi: 10.3389/fendo.2022.984561. eCollection 2022.

Abstract

OBJECTIVES

The relationship between renal function and diabetic retinopathy has been controversial. This study is to investigate the influence of renal function on the complex and surgical outcomes of proliferative diabetic retinopathy (PDR).

METHODS

This was a analysis of the CONCEPT clinical trial. A total of 45 eyes with PDR underwent vitrectomy were included. Based on the estimated glomerular filtration rate (eGFR), they were divided into abnormal renal function group () and normal renal function group (). Baseline PDR complex, intraoperative outcomes (Intraoperative bleeding, frequency of endodiathermy, surgical time, iatrogenic hole, and tamponade) and postoperative outcomes (logMAR best-corrected visual acuity, vitreous re-hemorrhage, and macular edema, follow up at postoperative 1 month and 3 months) were estimated. Vitreous, aqueous humor and serum were collected at the vitrectomy day and Vascular endothelia growth factor-A levels were quantified for all included patients using liquid chip method.

RESULTS

There was no significant difference in baseline PDR complex, intraoperative and postoperative outcomes between and (all P > 0.05). At the vitrectomy day, there was also no difference of Vascular endothelia growth factor-A levels in vitreous, aqueous humor and serum between the two groups (all P > 0.05).

CONCLUSION

Our results showed that the renal function seems not parallel to the severity of PDR, neither to the surgical outcomes. This might be interpreted by the similar Vascular endothelia growth factor-A levels in vitreous, aqueous humor and serum between the two groups.

摘要

目的

肾功能与糖尿病视网膜病变之间的关系一直存在争议。本研究旨在探讨肾功能对增生性糖尿病视网膜病变(PDR)复杂病变和手术结果的影响。

方法

这是对 CONCEPT 临床试验的分析。共纳入 45 只接受玻璃体切除术的 PDR 眼。根据估算的肾小球滤过率(eGFR),将其分为肾功能异常组()和肾功能正常组()。评估基线 PDR 复杂性、术中结果(术中出血、内透热治疗频率、手术时间、医源性裂孔和填塞)和术后结果(logMAR 最佳矫正视力、玻璃体积血和黄斑水肿,术后 1 个月和 3 个月随访)。在玻璃体切除术当天收集所有纳入患者的玻璃体、房水和血清,并使用液相芯片法定量血管内皮生长因子-A 水平。

结果

和组之间在基线 PDR 复杂性、术中及术后结果方面均无显著差异(均 P > 0.05)。在玻璃体切除术当天,两组之间的玻璃体、房水和血清中的血管内皮生长因子-A 水平也无差异(均 P > 0.05)。

结论

我们的结果表明,肾功能似乎与 PDR 的严重程度不平行,也与手术结果不平行。这可能可以解释两组之间的玻璃体、房水和血清中的血管内皮生长因子-A 水平相似。

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Screening for diabetic retinopathy: new perspectives and challenges.糖尿病视网膜病变筛查:新视角与新挑战。
Lancet Diabetes Endocrinol. 2020 Apr;8(4):337-347. doi: 10.1016/S2213-8587(19)30411-5. Epub 2020 Feb 27.

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