State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China.
Zhongs School of Medicine, Sun Yat-Sen University, Guangzhou, China.
Br J Ophthalmol. 2023 Dec 18;108(1):84-90. doi: 10.1136/bjo-2022-321603.
To investigate longitudinal choroid and ganglion cell-inner plexiform layer (GCIPL) changes in type 2 diabetes mellitus (T2DM) patients and healthy populations across 2 years.
This prospective cohort study included T2DM patients and healthy controls. T2DM patients were divided into mild non-proliferative diabetic retinopathy (NPDR) or non-DR (NDR) groups. Macular choroidal and GCIPL thickness was measured using swept-source optical coherence tomography at baseline and follow-up after 2 years. A linear-mixed effect model compared rates of change in choroidal and GCIPL thicknesses between the three groups.
895 T2DM patients (770 in the NDR group and 125 in the NPDR group) and 847 healthy controls were included. Following 2 years, choroidal thinning occurred at a rate of -7.7±9.2 µm/year, -8.1±8.7 µm/year and -5.2±8.1 µm/year in NDR, NPDR and control groups, respectively (p<0.001). GCIPL loss occurred quickest in NPDR patients (-0.97±0.97 µm/year), followed by NDR (-0.91±0.89 µm/year) and the control group (-0.04±0.55 µm/year) (p<0.001). Following multivariate adjustment, choroidal thinning was -2.04 µm/year (95% CI: -4.05 to -0.03; p=0.047) and -1.95 µm/year (95% CI: -3.14 to -0.75; p=0.001) faster in NPDR and NDR groups than in the control group, respectively, and GCIPL thinning was -1.02 µm/year (95% CI: -1.19 to -0.84; p<0.001) and -0.88 µm/year (95% CI: -0.98 to -0.78; p<0.001) faster in the NPDR and NDR groups than in the control group, respectively.
Progressive choroidal and GCIPL thinning occurs in healthy individuals and T2DM patients; however, T2DM undergoes accelerated choroidal and GCIPL loss in NPDR patients.
研究 2 年内 2 型糖尿病（T2DM）患者和健康人群的脉络膜和节细胞内丛状层（GCIPL）的纵向变化。
本前瞻性队列研究纳入了 T2DM 患者和健康对照者。T2DM 患者分为轻度非增生性糖尿病视网膜病变（NPDR）或非糖尿病视网膜病变（NDR）组。基线和 2 年后随访时，使用扫频源光学相干断层扫描测量黄斑脉络膜和 GCIPL 厚度。线性混合效应模型比较三组之间脉络膜和 GCIPL 厚度变化率。
纳入 895 例 T2DM 患者（NDR 组 770 例，NPDR 组 125 例）和 847 例健康对照者。2 年后，NDR、NPDR 和对照组脉络膜变薄速度分别为-7.7±9.2 μm/年、-8.1±8.7 μm/年和-5.2±8.1 μm/年（p<0.001）。NPDR 患者的 GCIPL 丢失最快（-0.97±0.97 μm/年），其次是 NDR 组（-0.91±0.89 μm/年）和对照组（-0.04±0.55 μm/年）（p<0.001）。多变量调整后，NPDR 组和 NDR 组脉络膜变薄速度分别比对照组快 2.04 μm/年（95%CI：-4.05 至 -0.03；p=0.047）和 1.95 μm/年（95%CI：-3.14 至 -0.75；p=0.001），GCIPL 变薄速度分别比对照组快 1.02 μm/年（95%CI：-1.19 至 -0.84；p<0.001）和 0.88 μm/年（95%CI：-0.98 至 -0.78；p<0.001）。
健康个体和 T2DM 患者均出现脉络膜和 GCIPL 进行性变薄，但 NPDR 的 T2DM 患者脉络膜和 GCIPL 丢失速度加快。
