Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, 106, Zhongshan 2Nd Road, Guangzhou, 510080, China.
Department of Ophthalmology, Linyi People's Hospital, Linyi, 276003, Shandong, China.
Graefes Arch Clin Exp Ophthalmol. 2024 Jan;262(1):61-72. doi: 10.1007/s00417-023-06238-3. Epub 2023 Sep 23.
This study aimed to investigate alterations of outer retinal reflectivity on spectral-domain optical coherence tomography (OCT) in diabetic patients without clinically detectable retinopathy (NDR).
In this retrospective study, 64 NDR patients and 71 controls were included. Relative reflectivity (RR) of the ellipsoid zone (EZ), photoreceptor outer segment (OS) and inner segment (IS), and outer nuclear layer (ONL) at the foveola and at 500 μm, 1000 μm, and 2000 μm nasal (N), temporal (T), superior (S), and inferior (I) to the foveola was measured by cross-line OCT and ImageJ. Retinal vessel densities (VD) in fovea, parafovea, and perifovea areas were detected by OCT angiography (OCTA).
EZ RR in most retinal locations was significantly lower in NDR eyes compared to controls (all P < 0.05), except the foveola. Compared with controls, NDR eyes also displayed lower RR at N2000, T2000, S1000, and I1000 of OS, at S500 and I500 of IS, and at I500 of ONL (all P < 0.05). Negative correlations could be observed between retinal RR and diabetes duration, HbA1c, and best-corrected visual acuity (BCVA) (r = - 0.303 to - 0.452). Compared to controls, EZ, OS, and IS RR of the NDR eyes showed lower correlation coefficients with whole image SCP and DCP VD of parafovea and perifovea regions.
Outer retinal reflectivity, along with the coefficients between retinal reflectivity and VD, is reduced in NDR patients and is correlated with diabetes duration, HbA1c, and BCVA. The reduction of outer retinal reflectivity may be a potential biomarker of early retinal alterations in diabetic patients.
本研究旨在探讨无临床可检测视网膜病变（NDR）的糖尿病患者的频域光学相干断层扫描（OCT）中外视网膜反射率的变化。
在这项回顾性研究中，纳入了 64 名 NDR 患者和 71 名对照者。通过十字线 OCT 和 ImageJ 测量黄斑区和距黄斑区 500μm、1000μm 和 2000μm 的鼻侧（N）、颞侧（T）、上侧（S）和下侧（I）的椭圆体带（EZ）、光感受器外节（OS）和内节（IS）以及外核层（ONL）的相对反射率（RR）。OCT 血管造影（OCTA）检测黄斑区、旁中心凹和中心凹周围的视网膜血管密度（VD）。
与对照组相比，NDR 眼在大多数视网膜位置的 EZ RR 明显降低（均 P<0.05），但黄斑区除外。与对照组相比，NDR 眼的 OS 在 N2000、T2000、S1000 和 I1000，IS 在 S500 和 I500，以及 ONL 在 I500 的 RR 也较低（均 P<0.05）。RR 与糖尿病病程、HbA1c 和最佳矫正视力（BCVA）呈负相关（r= - 0.303 至- 0.452）。与对照组相比，NDR 眼的 EZ、OS 和 IS RR 与旁中心凹和中心凹周围区域的 SCP 和 DCP 全像 VD 的相关性系数较低。
NDR 患者的外视网膜反射率以及视网膜反射率与 VD 的相关系数降低，与糖尿病病程、HbA1c 和 BCVA 相关。外视网膜反射率的降低可能是糖尿病患者早期视网膜改变的潜在生物标志物。
