Abstract：
OBJECTIVE: To identify specific markers indicative of macular neural and microvascular alterations in individuals with Type 2 Diabetes Mellitus (T2DM) without clinically observable retinopathy.
METHODS: Prospective cross-sectional study.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
METHODS: Prospective cross-sectional study.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.
摘要：
目的：在没有临床可观察到的视网膜病变的2型糖尿病（T2DM）患者中，确定指示黄斑神经和微血管改变的特异性标志物。
方法：前瞻性横断面研究。
方法：使用PLEXElite9000，所有眼睛都接受了扫频源光学相干断层扫描（SS-OCT）血管造影。获得的图像的定量分析将无视网膜病变的T2DM患者的黄斑神经和微血管改变与年龄匹配的对照进行了比较。精确评估包括测量每个单独视网膜层的厚度并评估不同毛细血管丛内的黄斑血管指数。
结果：参加了49名T2DM患者和51名年龄匹配的对照组。T2DM患者的神经节细胞内网状层（GC-IPL）的平均黄斑厚度显着降低（82.5±5.5μmvs.86.2±5.0μm,p=0.001）和黄斑视网膜神经纤维层（RNFL）（45.8±3.0μmvs.48.1±3.7μm,p=0.001)。此外，糖尿病眼黄斑全视网膜厚度明显低于对照组（324.9±16.3μmvs.332.8±13.7μm,p=0.009)。血管测量显示T2DM患者总毛细血管丛黄斑血管骨骼密度的细微变化（0.132±0.005vs.0.135±0.005，p=0.019）。
结论：从SS-OCT得出的指标，特别是黄斑RNFL和GC-IPL厚度，在没有临床上可观察到的视网膜病变的T2DM患者中，它是早期发现糖尿病视网膜疾病的优良指标。需要进一步的调查才能全面了解这些发现的临床意义。
方法：前瞻性横断面研究。
方法：使用PLEXElite9000，所有眼睛都接受了扫频源光学相干断层扫描（SS-OCT）血管造影。获得的图像的定量分析将无视网膜病变的T2DM患者的黄斑神经和微血管改变与年龄匹配的对照进行了比较。精确评估包括测量每个单独视网膜层的厚度并评估不同毛细血管丛内的黄斑血管指数。
结果：参加了49名T2DM患者和51名年龄匹配的对照组。T2DM患者的神经节细胞内网状层（GC-IPL）的平均黄斑厚度显着降低（82.5±5.5μmvs.86.2±5.0μm,p=0.001）和黄斑视网膜神经纤维层（RNFL）（45.8±3.0μmvs.48.1±3.7μm,p=0.001)。此外，糖尿病眼黄斑全视网膜厚度明显低于对照组（324.9±16.3μmvs.332.8±13.7μm,p=0.009)。血管测量显示T2DM患者总毛细血管丛黄斑血管骨骼密度的细微变化（0.132±0.005vs.0.135±0.005，p=0.019）。
结论：从SS-OCT得出的指标，特别是黄斑RNFL和GC-IPL厚度，在没有临床上可观察到的视网膜病变的T2DM患者中，它是早期发现糖尿病视网膜疾病的优良指标。需要进一步的调查才能全面了解这些发现的临床意义。
