Shanxi Eye Hospital Affiliated to Shanxi Medical University (Y.D., D.Z., J.Z., K.W., G.Z.), Taiyuan, Shanxi, China.
School of Precision Instruments and Opto-electronics Engineering (B.F., S.W., C.L.), Tianjin University, Tianjin, China.
Am J Ophthalmol. 2024 Jun;262:229-236. doi: 10.1016/j.ajo.2024.02.034. Epub 2024 Feb 28.
To identify specific markers indicative of macular neural and microvascular alterations in individuals with Type 2 Diabetes Mellitus (T2DM) without clinically observable retinopathy.
Prospective cross-sectional study.
Using the PLEX Elite 9000, all eyes underwent swept-source optical coherence tomography (SS-OCT) angiography. Quantitative analysis of acquired images compared macular neural and microvascular alterations in T2DM patients without retinopathy to age-matched controls. Precise assessments encompassed measuring the thickness of each individual retinal layer and evaluating macular vascular indices within different capillary plexuses.
Forty-nine T2DM patients and 51 age-matched controls participated. T2DM patients exhibited a significant reduction in the mean macular thickness of the ganglion cell-inner plexiform layer (GC-IPL) (82.5 ± 5.5 µm vs 86.2 ± 5.0 µm, P = .001) and macular retinal nerve fiber layer (RNFL) (45.8 ± 3.0 µm vs 48.1 ± 3.7 µm, P = .001). Furthermore, macular full retinal thickness was significantly lower in diabetic eyes than controls (324.9 ± 16.3 µm vs 332.8 ± 13.7 µm, P = .009). Vascular measurements revealed subtle changes in macular vascular skeleton density within the total capillary plexuses in T2DM patients (0.132 ± 0.005 vs 0.135 ± 0.005, P = .019).
Metrics derived from SS-OCT, particularly macular RNFL and GC-IPL thicknesses, emerged as superior indicators for the early detection of diabetic retinal disease in individuals with T2DM without clinically observable retinopathy. Further investigations are warranted to comprehensively understand the clinical implications of these findings.
在没有临床可见视网膜病变的 2 型糖尿病（T2DM）患者中，确定特定的标志物以指示黄斑神经和微血管改变。
前瞻性横断面研究。
使用 PLEX Elite 9000，所有眼睛均接受扫频源光学相干断层扫描（SS-OCT）血管造影检查。对获得的图像进行定量分析，比较无糖尿病视网膜病变的 T2DM 患者与年龄匹配的对照组之间的黄斑神经和微血管改变。精确评估包括测量每个视网膜层的厚度，并评估不同毛细血管丛中的黄斑血管指数。
49 名 T2DM 患者和 51 名年龄匹配的对照组参与了研究。T2DM 患者的平均黄斑神经节细胞-内丛状层（GC-IPL）厚度（82.5 ± 5.5 µm 比 86.2 ± 5.0 µm，P =.001）和黄斑视网膜神经纤维层（RNFL）厚度（45.8 ± 3.0 µm 比 48.1 ± 3.7 µm，P =.001）明显降低。此外，糖尿病患者的黄斑全视网膜厚度明显低于对照组（324.9 ± 16.3 µm 比 332.8 ± 13.7 µm，P =.009）。血管测量显示，T2DM 患者的总毛细血管丛中黄斑血管骨架密度有细微变化（0.132 ± 0.005 比 0.135 ± 0.005，P =.019）。
来自 SS-OCT 的指标，特别是黄斑 RNFL 和 GC-IPL 厚度，是在没有临床可见视网膜病变的 T2DM 患者中早期发现糖尿病视网膜疾病的更好指标。需要进一步研究以全面了解这些发现的临床意义。
