目的:评价糖尿病视网膜病变(DR)患者视网膜神经变性和脉络膜厚度的纵向变化。
方法:前瞻性观察性队列研究。
方法:这项前瞻性观察性队列研究招募了广州社区注册的2型糖尿病患者。所有参与者通过扫频源光学相干断层扫描进行年度眼部检查,获得脉络膜厚度(CT),视网膜厚度(RT),神经节细胞内丛状层(GC-IPL)厚度。GC-IPL的变化,CT,在3年的随访期间,比较了发生DR(IDR)或非DR(NDR)的患者之间的RT.
结果:在924名患者中,159例(17.2%)患者在3年的随访中出现IDR。减少GC-IPL,RT,在NDR和IDR中观察到CT;然而,IDR患者的CT减薄明显加快,IDR患者的平均CT降低为-6.98(95%CI:-8.26,-5.71)μm/y,NDR患者的平均CT降低为-3.98(95%CI:-4.60,-3.36)μm/y(P<.001)。IDR患者在3年内平均GC-IPL厚度减少为-0.97(95%CI:-1.24,-0.70)μm/y,NDR患者为-0.76(95%CI:-0.82,-0.70)μm/y(P=0.025)。在调整混杂因素后,与保持NDR的患者相比,IDR患者的平均CT和GC-IPL变薄明显快于2.09μm/y(95%CI:1.01,3.16;P=.004)和-0.29μm/y(95%CI:-0.49,-0.09;P=.004),分别。IDR组的RT增加,而NDR组的RT随着时间的推移而下降,中心场RT的调整差值为2.09μm/y(95%CI:1.01,3.16;P<.001)。
结论:在3年的随访期间,发生IDR和保持NDR的眼睛之间,视网膜神经变性和CT变薄的发生率有显著差异,但两组均观察到厚度减少。这表明GC-IPL和CTs可能在DR临床表现之前降低。
To evaluate the longitudinal changes of retinal neurodegeneration and choroidal thickness in diabetic patients with and without diabetic retinopathy (DR).
Prospective observational cohort
study.
This prospective observational cohort
study recruited type 2 diabetic patients from a community registry in Guangzhou. All participants underwent annual ocular examinations via swept-source optical coherence tomography that obtained choroid thickness (CT), retinal thickness (RT), and ganglion cell-inner plexiform layer (GC-IPL) thickness. The changes in GC-IPL, CT, and RT between patients who developed incident DR (IDR) or remained non-DR (NDR) were compared during a 3-year follow-up.
Among 924 patients, 159 (17.2%) patients developed IDR within the 3-year follow-up. A reduction in GC-IPL, RT, and CT was observed in NDR and IDR; however, CT thinning in patients with IDR was significantly accelerated, with an average CT reduction of -6.98 (95% CI: -8.26, -5.71) μm/y in patients with IDR and -3.98 (95% CI: -4.60, -3.36) μm/y in NDR patients (P < .001). Reductions in average GC-IPL thickness over 3 years were -0.97 (95% CI: -1.24, -0.70) μm/y in patients with IDR and -0.76 (95% CI: -0.82, -0.70) μm/y in NDR patients (P = .025). After adjusting for confounding factors, the average CT and GC-IPL thinning were significantly faster in patients with IDR compared with those who remained NDR by 2.09 μm/y (95% CI: 1.01, 3.16; P = .004) and -0.29 μm/y (95% CI: -0.49, -0.09; P = .004), respectively. The RT in the IDR group increased, whereas the RT in the NDR group decreased over time, with the adjusted difference of 2.09 μm/y (95% CI: 1.01, 3.16; P < .001) for central field RT.
The rate of retinal neurodegeneration and CT thinning were significantly different between the eyes that developed IDR and remained NDR during the 3-year follow-up, but both groups observed thickness reduction. This indicates that GC-IPL and CTs may decrease before the clinical manifestations of DR.