医学
糖尿病性视网膜病变
前瞻性队列研究
眼科
队列
视网膜
脉络膜
内科学
作者
Yining Huang,Nuan Zhang,Gabriella Bulloch,Shiran Zhang,Xianwen Shang,Yifan Chen,Huan Liao,Zhuoting Zhu,Wei Wang
标识
DOI:10.1016/j.ajo.2022.07.011
摘要
To evaluate the longitudinal changes of retinal neurodegeneration and choroidal thickness in diabetic patients with and without diabetic retinopathy (DR).Prospective observational cohort study METHODS: : This prospective observational cohort study recruited type 2 diabetic patients from a community registry in Guangzhou. All participants underwent annual ocular examinations via SS-OCT which obtained choroid thickness (CT), retinal thickness (RT), and ganglion cell-inner plexiform layer (GCIPL) thickness. The change in GCIPL, 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 GCIPL, RT, and CT was observed in NDR and IDR, however CT thinning in IDR patients was significantly accelerated, with an average CT reduction of-6.98 (95%CI: -8.26, -5.71) μm/year in patients with IDR, and -3.98 (95%CI: -4.60, -3.36) μm/year in NDR patients (P<0.001). Reductions in average GCIPL thickness over 3 years were -0.97 (95%CI: -1.24, -0.70) μm/year in IDR patients, and -0.76 (95%CI: -0.82, -0.70) μm/year in NDR patients (P=0.025). After adjusting for confounding factors, the average CT and GCIPL thinning was significantly faster in IDR patients compared with those whom remained NDR by 2.09 μm/year (95%CI:1.01, 3.16; P=0.004) and -0.29 μm/year (95%CI: -0.49, -0.09; P=0.004), respectively. The RT in the IDR group increased, while the RT in NDR group decreased overtime, with the adjusted difference of 2.09 μm/year (95%CI: 1.01, 3.16; P <0.001) for central field RT.The rate of retinal neurodegeneration and CT thinning were significantly different between eyes that developed IDR and remained NDR during the 3-year follow-up, but both groups observed thickness reduction. This indicates GCIPL and choroid thicknesses may decrease before the clinical manifestations of DR.
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