Gamal El-Deen Asmaa Mohammed, Abd El-Hamid Samar Mohammed, Farrag Enas Ahmed
Department of Ophthalmology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Taiwan J Ophthalmol. 2023 Mar 21;14(3):422-430. doi: 10.4103/tjo.TJO-D-22-00143. eCollection 2024 Jul-Sep.
To investigate the relationship between serum brain-derived neurotrophic factor (BDNF) and changes in macular perfusion in different stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).
The study was conducted on 72 eyes of people with type 2 diabetes mellitus (DM). They were divided into five groups based on their DR stage: no DR (nDR), mild and moderate nonproliferative DR, severe nonproliferative DR, active proliferative DR (aPDR), and stable PDR. The presence or absence of diabetic maculopathy was also used to categorize the cases. All patients underwent a complete history, ophthalmological examination, OCTA imaging, and evaluation of BDNF and glycated hemoglobin A1c levels.
The mean blood BDNF levels in the aPDR group were considerably lower than those in the nDR group ( = 0.023). In comparison to eyes without maculopathy, eyes with maculopathy had considerably decreased mean blood BDNF levels ( = 0.0004). Comparing NPDR and PDR groups to nDR as well as NPDR and PDR, a substantial decrease in average and parafoveal vessel density (VD) of the retina and choriocapillaries was seen ( = 0.02). The Foveal Avascular Zone (FAZ) acircularity index and VD were found to be significantly impacted by deteriorating DR ( = 0.001 and 0.017, respectively). It was discovered that there is a positive correlation between BDNF and the FAZ fractal dimension ( = 0.03). In diabetic eyes, there was a statistically favorable correlation between BDNF levels and best corrected visual acuity ( = 0.002). Furthermore, there was a negative relationship between DM duration and BDNF ( = 0.021).
Serum BDNF levels decreased with the progression of DR and in patients with maculopathy. BDNF was found to be related to macular perfusion, particularly in the fovea.
使用光学相干断层扫描血管造影（OCTA）研究血清脑源性神经营养因子（BDNF）与糖尿病视网膜病变（DR）不同阶段黄斑灌注变化之间的关系。
对72例2型糖尿病（DM）患者的眼睛进行研究。根据DR分期将他们分为五组：无DR（nDR）、轻度和中度非增殖性DR、重度非增殖性DR、活动性增殖性DR（aPDR）和稳定增殖性DR。是否存在糖尿病性黄斑病变也用于对病例进行分类。所有患者均接受了完整的病史、眼科检查、OCTA成像以及BDNF和糖化血红蛋白A1c水平评估。
aPDR组的平均血液BDNF水平明显低于nDR组（P = 0.023）。与无黄斑病变的眼睛相比，有黄斑病变的眼睛平均血液BDNF水平明显降低（P = 0.0004）。将NPDR组和PDR组与nDR组以及NPDR组和PDR组进行比较，视网膜和脉络膜毛细血管的平均和黄斑旁血管密度（VD）显著降低（P = 0.02）。发现黄斑无血管区（FAZ）的非圆形指数和VD受DR恶化的显著影响（分别为P = 0.001和0.017）。发现BDNF与FAZ分形维数之间存在正相关（P = 0.03）。在糖尿病眼中，BDNF水平与最佳矫正视力之间存在统计学上的良好相关性（P = 0.002）。此外，DM病程与BDNF之间存在负相关（P = 0.021）。
血清BDNF水平随DR进展和黄斑病变患者而降低。发现BDNF与黄斑灌注有关，特别是在黄斑中心凹。
