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早期糖尿病视网膜病变的角膜和视网膜神经元变性

Srinivasan, S., Dehghani, C., Pritchard, N., et al.

期刊名称:Investigative Ophthalmology & Visual Science

卷期:2017年第58卷第14期

摘要

摘要:目的:旨在研究角膜和视网膜神经元作为非增殖性糖尿病视网膜病变(NPDR)中神经元变性标志物的结构完整性。方法:研究对象从澳大利亚昆士兰州的布里斯班社区招募。对214名受试者(187例糖尿病患者和54例非糖尿病患者)进行了检查。根据早期糖尿病视网膜病变研究(ETDRS)量表对糖尿病视网膜病变(DR)进行分级。对角膜神经纤维长度(CNFL),角膜神经分支密度(CNBD),角膜神经纤维迂曲度(CNFT),全视网膜厚度,视网膜神经纤维层(RNFL),神经节细胞复合体(GCC),局部(FLV)和全眼丢失量(GLV),血红蛋白A1cHbA1c),肾病,神经病和心血管指标进行检测。结果:组间中央区(P = 0.174),旁中心凹厚度(P = 0.090),中心凹周围(P = 0.592),RNFLP = 0.866),GCCP = 0.798)和GCC GLVP = 0.338)没有明显差异。与对照组相比,非常轻微NPDR和轻度NPDR患者GCC体积中的局灶性损失明显更高(P = 0.036)。轻度NPDR患者的CNFL明显低于对照组和无DR患者(P = 0.004)。 两组间CNBDP = 0.094)和CNFTP = 0.458)没有差异。结论:角膜和视网膜神经元变性可能发生于糖尿病视网膜病变的早期阶段。在缺乏DR临床症状的情况下,需要进一步的研究来检查这些潜在的神经元变性的标志物。

Purpose:To examine the neuronal structural integrity of cornea and retina as markers for neuronal degeneration in nonproliferative diabetic retinopathy (NPDR).Methods:Participants were recruited from the broader Brisbane community, Queensland, Australia. Two hundred forty-one participants (187 with diabetes and 54 nondiabetic controls) were examined. Diabetic retinopathy (DR) was graded according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Corneal nerve fiber length (CNFL), corneal nerve branch density (CNBD), corneal nerve fiber tortuosity (CNFT), full retinal thickness, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), focal (FLV) and global loss volumes (GLV), hemoglobin A1c (HbA1c), nephropathy, neuropathy, and cardiovascular measures were examined.Results:The central zone (P = 0.174), parafoveal thickness (P = 0.090), perifovea (P = 0.592), RNFL (P = 0.866), GCC (P = 0.798), and GCC GLV (P = 0.338) did not differ significantly between the groups. In comparison to the control group, those with very mild NPDR and those with mild NPDR had significantly higher focal loss in GCC volume (P = 0.036). CNFL was significantly lower in those with mild NPDR (P = 0.004) in comparison to the control group and those with no DR. The CNBD (P = 0.094) and CNFT (P = 0.458) did not differ between the groups.Conclusions:Both corneal and retinal neuronal degeneration may occur in early stages of diabetic retinopathy. Further studies are required to examine these potential markers for neuronal degeneration in the absence of clinical signs of DR.


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