青少年 1 型糖尿病和成人 2 型糖尿病患者虹膜不同区域血管密度和血流分布的差异。

Discrepancies in Vessel Density and Blood Flow Distribution in Different Areas of the Iris among Pediatric Type 1 Diabetes Mellitus and Adult Type 2 Diabetes Mellitus Patients.

机构信息

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China,

Department of Ophthalmology, Children's Hospital of Fudan University, Shanghai, China.

出版信息

Ophthalmic Res. 2023;66(1):1139-1147. doi: 10.1159/000533278. Epub 2023 Aug 14.

DOI:10.1159/000533278

PMID:37579732

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10614557/

Abstract

INTRODUCTION

Diabetes mellitus may compromise the vasculature of the iris, thereby leading to severe vision-threatening complications. This study aimed to investigate differences in iris blood flow indices between pediatric type 1 diabetes mellitus (T1DM) patients and adult type 2 diabetes mellitus (T2DM) patients.

METHODS

This was a cross-sectional study. Pediatric T1DM patients and healthy children were members of the Shanghai Children and Adolescent Diabetes Eye (SCADE) cohort who visited Shanghai Eye Hospital in February 2022. The adult T2DM patients and healthy adults were patients who visited Shanghai General Hospital from October 2021 to January 2022. Iris OCTA was acquired through a Cirrus HD-OCT 5000 angiography system (Carl Zeiss Meditec, Inc.). A unique iris OCTA quantification method was used, and the vessel area density (VAD) and vessel skeleton density (VSD) were obtained. The area from the pupillary margin to the corneoscleral limbus was taken as the whole iris blood flow index, and the inner third near the pupillary margin of the whole iris was taken as the pupillary margin blood flow index.

RESULTS

This study enrolled 34 pediatric T1DM patients, 34 age-matched healthy children, 34 adult T2DM patients, and 34 age-matched healthy adults. The whole iris and pupillary margin VAD and VSD of the pediatric T1DM patients were not different from those of healthy children. The whole iris VAD and VSD of the adult T2DM patients were lower than those of healthy adults, and the pupillary margin VAD and VSD were the same in these two groups. Compared with adult T2DM patients, pediatric T1DM patients had higher whole iris VAD and VSD and lower pupillary margin VAD and VSD values, all with statistical significance. Among diabetic patients, age, BMI, and glycated hemoglobin level were negative independent influencing factors for whole iris VAD and VSD, and age was a positive influencing factor for pupillary margin VAD and VSD.

CONCLUSION

There are diverse alterations in iris vessel density and blood flow distribution between pediatric T1DM patients and adult T2DM patients.

摘要

简介

糖尿病可能会损害虹膜血管，从而导致严重的威胁视力的并发症。本研究旨在探讨儿童 1 型糖尿病（T1DM）患者和成人 2 型糖尿病（T2DM）患者之间虹膜血流指数的差异。

方法

这是一项横断面研究。儿童 T1DM 患者和健康儿童是 2022 年 2 月在上海眼耳鼻喉科医院就诊的上海儿童青少年糖尿病眼病（SCADE）队列的成员。成人 T2DM 患者和健康成年人是 2021 年 10 月至 2022 年 1 月在上海总医院就诊的患者。虹膜 OCTA 通过 Cirrus HD-OCT 5000 血管造影系统（卡尔蔡司医疗技术公司）获得。采用独特的虹膜 OCTA 量化方法，获得血管面积密度（VAD）和血管骨架密度（VSD）。从瞳孔缘到角巩膜缘的区域被视为整个虹膜血流指数，而整个虹膜的内三分之一靠近瞳孔缘的区域被视为瞳孔缘血流指数。

结果

本研究纳入了 34 例儿童 T1DM 患者、34 名年龄匹配的健康儿童、34 例成人 T2DM 患者和 34 名年龄匹配的健康成年人。儿童 T1DM 患者的整个虹膜和瞳孔缘 VAD 和 VSD 与健康儿童无差异。成人 T2DM 患者的整个虹膜 VAD 和 VSD 低于健康成年人，而两组的瞳孔缘 VAD 和 VSD 相同。与成人 T2DM 患者相比，儿童 T1DM 患者的整个虹膜 VAD 和 VSD 较高，而瞳孔缘 VAD 和 VSD 较低，差异均有统计学意义。在糖尿病患者中，年龄、BMI 和糖化血红蛋白水平是整个虹膜 VAD 和 VSD 的负独立影响因素，年龄是瞳孔缘 VAD 和 VSD 的正影响因素。