Ab Rahman Nurshazwani, Chellapan Kalaivani, Ong Poh Yan, Adnan Azian, Md Din Norshamsiah
Department of Ophthalmology, Hospital Selayang, Selangor, Malaysia.
Department of Electrical, Electronics and System, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Selangor, Malaysia ; and.
Retina. 2025 Feb 1;45(2):310-317. doi: 10.1097/IAE.0000000000004297.
To evaluate systemic vascular fitness measured by finger photoplethysmography in diabetic retinopathy (DR).
This was a cross-sectional observational study on patients with Type II diabetes mellitus from October 2020 to May 2021. Data collected include systolic/diastolic blood pressure, visual acuity, glycated hemoglobin, and central macular thickness. Diabetic retinopathy severity was categorized using the Early Treatment Diabetic Retinopathy Study classification. Photoplethysmography signals were acquired using pulse-oximeter modules (OEM-60; Dolphin Medical, Inc) measured for 90 seconds at 275 Hz sampling rate and 16-bit resolution, which records photoplethysmography fitness index, vascular risk prediction index, and vascular age.
One hundred and forty-one patients were equally distributed into six DR categories. Mean age was 58.8 ± 9.9 years, with female-to-male ratio of 1.27. There were significant differences in mean systolic (125.5 ± 10.0 mmHg, P = 0.007) and diastolic blood pressure (80.0 ± 8.8 mmHg), mean glycated hemoglobin (7.6 ± 1.9%, P = 0.005), median log unit of minimal angle of resolution (0.3, interquartile range: 0.2-0.5, P < 0.001), and central macular thickness ( P = 0.003) across DR severity. Significant differences were also seen in photoplethysmography fitness index ( P = 0.001), vascular risk prediction index ( P < 0.001), and vascular age ( P = 0.001), with poorer values in severe compared with mild/moderate DR. After adjusting for age, blood pressure, and glycated hemoglobin, photoplethysmography fitness reduces by 3.3% (regression coefficient, b = -3.27, P < 0.001), vascular age increases by 2.5 years ( b = 2.54, P = 0.002), and vascular risk prediction index increases by 3.1 ( b = 3.08, P < 0.001) with every DR worsening.
More severe DR stages were associated with poorer photoplethysmography vascular markers.
评估通过手指光电容积脉搏波描记法测量的糖尿病视网膜病变（DR）患者的全身血管健康状况。
这是一项针对2020年10月至2021年5月期间的II型糖尿病患者的横断面观察性研究。收集的数据包括收缩压/舒张压、视力、糖化血红蛋白和黄斑中心厚度。使用糖尿病视网膜病变早期治疗研究分类法对糖尿病视网膜病变的严重程度进行分类。使用脉搏血氧仪模块（OEM - 60；海豚医疗公司）以275Hz采样率和16位分辨率采集90秒的光电容积脉搏波描记法信号，该模块记录光电容积脉搏波描记法健康指数、血管风险预测指数和血管年龄。
141名患者被平均分为六个DR类别。平均年龄为58.8±9.9岁，女性与男性比例为1.27。在平均收缩压（125.5±10.0mmHg，P = 0.007）和舒张压（80.0±8.8mmHg）、平均糖化血红蛋白（7.6±1.9%，P = 0.005）、最小分辨角的中位数对数单位（0.3，四分位间距：0.2 - 0.5，P < 0.001）以及黄斑中心厚度（P = 0.003）方面，不同DR严重程度之间存在显著差异。在光电容积脉搏波描记法健康指数（P = 0.001）、血管风险预测指数（P < 0.001）和血管年龄（P = 0.001）方面也存在显著差异，与轻度/中度DR相比，重度DR的这些值更差。在调整年龄、血压和糖化血红蛋白后，随着DR病情每加重一级，光电容积脉搏波描记法健康指数降低3.3%（回归系数，b = -3.27，P < 0.001），血管年龄增加2.5岁（b = 2.54，P = 0.002），血管风险预测指数增加3.1（b = 3.08，P < 0.001）。
更严重的DR阶段与较差的光电容积脉搏波描记法血管标志物相关。
