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眼灌注压和脑脊液压力与糖尿病视网膜病变变化的关系。

ASSOCIATION OF OCULAR PERFUSION PRESSURE AND CEREBROSPINAL FLUID PRESSURE WITH CHANGES IN DIABETIC RETINOPATHY.

机构信息

National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.

Fushun Eye Hospital, Fushun, Liaoning, China; and.

出版信息

Retina. 2023 Jul 1;43(7):1107-1113. doi: 10.1097/IAE.0000000000003792.

Abstract

PURPOSE

To investigate the association between mean ocular perfusion pressure (MOPP), estimated cerebrospinal fluid pressure (CSFP), and changes in diabetic retinopathy (DR) in a Northeastern Chinese population with Type 2 diabetes.

METHODS

A total of 1,322 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and intraocular pressure (IOP) were recorded. MOPP was calculated by the following formula: MOPP = 2/3 [DBP + 1/3 (SBP - DBP)] - IOP, and CSFP was estimated according to the following formula: CSFP = 0.44 × body mass index + 0.16 × DBP - 0.18 × age - 1.91. New development, progression, and regression of DR were graded based on fundus photographs at baseline and during follow-up examinations with a mean interval of 21.2 months using the modified Early Treatment Diabetic Retinopathy Study criteria.

RESULTS

Increasing MOPP was associated with the incidence of DR in the multivariate model (per 1-mmHg increase: relative risk, 1.06; 95% confidence interval, 1.02-1.10; P = 0.007) and showed a borderline negative association with DR regression (per 1-mmHg increase: relative risk, 0.98; 95% confidence interval, 0.97-1.00; P = 0.053). However, MOPP was not associated with progression of DR. Cerebrospinal fluid pressure was not associated with new development, progression, or regression of DR.

CONCLUSION

The MOPP, but not the CSFP, was found to influence the development, but not the progression of DR in this Northeastern Chinese cohort.

摘要

目的

调查在中国东北 2 型糖尿病人群中,平均眼灌注压(MOPP)、估计的脑脊液压力(CSFP)与糖尿病视网膜病变(DR)变化之间的关系。

方法

共纳入来自抚顺糖尿病视网膜病变队列研究的 1322 名受试者。记录收缩压(SBP)、舒张压(DBP)和眼内压(IOP)。MOPP 通过以下公式计算:MOPP = 2/3 [DBP + 1/3 (SBP - DBP)] - IOP,CSFP 根据以下公式估计:CSFP = 0.44 × 体重指数 + 0.16 × DBP - 0.18 × 年龄 - 1.91。根据眼底照片,使用改良的早期糖尿病视网膜病变研究标准,在基线和随访检查时对 DR 的新发病、进展和消退进行分级,平均随访间隔为 21.2 个月。

结果

在多变量模型中,MOPP 的增加与 DR 的发生率相关(每增加 1mmHg:相对风险 1.06;95%置信区间 1.02-1.10;P = 0.007),并且与 DR 消退呈边缘负相关(每增加 1mmHg:相对风险 0.98;95%置信区间 0.97-1.00;P = 0.053)。然而,MOPP 与 DR 的进展无关。CSFP 与 DR 的新发、进展或消退无关。

结论

在本东北中国人群队列中,MOPP 而不是 CSFP 被发现影响 DR 的发生,但不影响其进展。

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