Guo Xiao, Zhu Zhuoting, Cheng Weijing, Bulloch Gabriella, Zhang Wenbin, Chen Yifan, Li Yuting, Liang Xiaoling, Huang Wenyong, Wang Wei
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, China.
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Ophthalmol Sci. 2023 Jul 3;4(1):100358. doi: 10.1016/j.xops.2023.100358. eCollection 2024 Jan-Feb.
To assess the relationship between optic disc microvasculature and renal function in subjects with diabetes mellitus without diabetic retinopathy (DR).
Prospective, cross-sectional study.
A total 1629 patients with type 2 diabetes mellitus without DR were recruited from the community of Guangzhou, China.
All subjects underwent 6 mm × 6 mm OCT angiography (OCTA) centered on the optic nerve head. Four state-of-the-art microcirculation parameters, including peripapillary vessel density (PVD) in the radial peripapillary capillaries (RPC), superficial capillary plexus, deep capillary plexus (DCP), and a choriocapillaris flow void density percentage (CC FVD%) were assessed via swept-source OCTA.
Renal function was assessed by levels of microalbuminuria (MAU) and estimated glomerular filtration rate (eGFR).
Compared with non-chronic kidney disease (CKD) participants, PVD was significantly lower in subjects in the CKD group and worsened as eGFR declined. After adjustment for covariates, higher eGFR was significantly associated with higher PVD in the RPC (β = 0.01; 95% confidence interval [CI], 0.01-0.02; < 0.001), in the superficial capillary plexus (β = 0.010; 95% CI, 0.002-0.019; = 0.020), in the DCP (β = 0.02; 95% CI, 0.01-0.03; < 0.001), and lower CC FVD% (β = -0.01; 95% CI, -0.03 to -0.001; = 0.040) in the entire images. After they were fully adjusted, the parameters in the inner ring of the RPC, DCP, and CC FVD% were significantly associated with MAU ( < 0.05).
Decrease in retinal and choroidal microcirculation in the optic nerve head was independently associated with renal dysfunction. Further longitudinal studies are needed to clarify the peripapillary vessel changes during CKD progression.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估无糖尿病视网膜病变（DR）的糖尿病患者视盘微血管与肾功能之间的关系。
前瞻性横断面研究。
从中国广州社区招募了总共1629例无DR的2型糖尿病患者。
所有受试者均接受以视乳头为中心的6mm×6mm光学相干断层扫描血管造影（OCTA）。通过扫频源OCTA评估四个最先进的微循环参数，包括放射状视乳头周围毛细血管（RPC）、浅表毛细血管丛、深部毛细血管丛（DCP）中的视乳头周围血管密度（PVD）以及脉络膜毛细血管血流缺失密度百分比（CC FVD%）。
通过微量白蛋白尿（MAU）水平和估计肾小球滤过率（eGFR）评估肾功能。
与非慢性肾脏病（CKD）参与者相比，CKD组受试者的PVD显著降低，且随着eGFR下降而恶化。在对协变量进行调整后，较高的eGFR与RPC（β = 0.01；95%置信区间[CI]，0.01 - 0.02；P < 0.001）、浅表毛细血管丛（β = 0.010；95%CI，0.002 - 0.019；P = 0.020）、DCP（β = 0.02；95%CI，0.01 - 0.03；P < 0.001）中较高的PVD以及整个图像中较低的CC FVD%（β = -0.01；95%CI，-0.03至-0.001；P = 0.040）显著相关。在进行全面调整后，RPC内环、DCP和CC FVD%中的参数与MAU显著相关（P < 0.05）。
视乳头处视网膜和脉络膜微循环的减少与肾功能障碍独立相关。需要进一步的纵向研究来阐明CKD进展过程中视乳头周围血管的变化。
作者对本文讨论的任何材料均无所有权或商业利益。
