根据糖尿病视网膜病变的严重程度，视乳头周围微血管和视网膜神经纤维层的损伤情况。

Peripapillary microvasculature and retinal nerve fiber layer damage according to the severity of diabetic retinopathy.

作者信息

Lee Min-Woo, Kim Jung-Tae, Seong Hyun-Je, Nam Ki-Yup

机构信息

Department of Ophthalmology, Konyang University College of Medicine, 1643 Gwanjeo-Dong, Seo-Gu, Daejeon, Republic of Korea.

Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Republic of Korea.

出版信息

Acta Diabetol. 2024 Oct;61(10):1293-1300. doi: 10.1007/s00592-024-02308-y. Epub 2024 May 24.

DOI:10.1007/s00592-024-02308-y

PMID:38789611

Abstract

PURPOSE

To identify damage to the inner retinal layer and microvasculature in the peripapillary area according to the severity of diabetic retinopathy (DR).

METHODS

Patients were divided into four groups: control (group 1), type 2 diabetes (T2DM) without DR (group 2), mild to moderate nonproliferative DR (NPDR) (group 3), and severe NPDR (group 4). The peripapillary retinal nerve fiber layer (pRNFL) thickness and peripapillary vessel density (VD) were compared. Linear regression analysis was performed to identify factors associated with the DR severity.

RESULTS

The average pRNFL thicknesses were 96.2 ± 7.1, 94.1 ± 9.6, 92.0 ± 9.9, and 90.3 ± 12.4 μm in groups 1, 2, 3, and 4, respectively (P = 0.003) (post hoc analyses: group 1 vs. group 2, P = 0.529; group 2 vs. group 3, P = 0.627; group 2 vs. group 4, P = 0.172; group 3 vs. group 4, P = 0.823). The VDs of the outer ring were 18.9 ± 0.6, 18.4 ± 0.8, 17.9 ± 1.1, and 17.3 ± 1.6 mm in groups 1, 2, 3 and 4, respectively (P < 0.001) (all pairwise comparisons, P < 0.050). In multivariate analysis, the VD of the outer ring (B = - 0.35, P < 0.001) was significantly associated with the DR severity.

CONCLUSIONS

The peripapillary microvasculature reflects retinal damage following DR progression better than the structure of the pRNFL.

摘要

目的

根据糖尿病视网膜病变（DR）的严重程度，确定视乳头周围区域视网膜内层和微血管的损伤情况。

方法

将患者分为四组：对照组（第1组）、无DR的2型糖尿病（T2DM）患者（第2组）、轻度至中度非增殖性DR（NPDR）患者（第3组）和重度NPDR患者（第4组）。比较视乳头周围视网膜神经纤维层（pRNFL）厚度和视乳头周围血管密度（VD）。进行线性回归分析以确定与DR严重程度相关的因素。

结果

第1、2、3和4组的平均pRNFL厚度分别为96.2±7.1、94.1±9.6、92.0±9.9和90.3±12.4μm（P = 0.003）（事后分析：第1组与第2组，P = 0.529；第2组与第3组，P = 0.627；第2组与第4组，P = 0.172；第3组与第4组，P = 0.823）。第1、2、3和4组外环的VD分别为18.9±0.6、18.4±0.8、17.9±1.1和17.3±1.6mm（P < 0.001）（所有两两比较，P < 0.050）。在多变量分析中，外环的VD（B = -0.35，P < 0.001）与DR严重程度显著相关。