Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy.

IF 2.4 3区 医学 Q2 OPHTHALMOLOGY Graefe’s Archive for Clinical and Experimental Ophthalmology Pub Date : 2024-12-01 Epub Date: 2024-06-15 DOI:10.1007/s00417-024-06552-4
Berthold Pemp, Stefan Palkovits, Stefan Sacu, Doreen Schmidl, Gerhard Garhöfer, Leopold Schmetterer, Ursula Schmidt-Erfurth
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Abstract

Purpose: Neurovascular coupling impairment and inner retinal layer thinning are early detectable retinal changes in diabetes, and both worsen during progression of diabetic retinopathy (DR). However, direct interactions between these features have not been investigated so far. Therefore, we aimed to analyze associations between the retinal functional hyperemic response to light stimulation and the thickness of individual neuroretinal layers in eyes with early non-proliferative DR.

Methods: Thirty patients with type 1 diabetes featuring mild (n = 15) or moderate (n = 15) non-proliferative DR and 14 healthy subjects were included in this cross-sectional study. Retinal vessel diameters were measured before and during illumination with flickering light using a dynamic vessel analyzer. Individual layer thickness in the macula was analyzed from spectral domain optical coherence tomography.

Results: Flicker light-induced vessel dilation was significantly reduced in patients compared to healthy controls (veins: 3.0% vs. 6.1%, p < 0.001; arteries: 1.3% vs. 5.1%, p = 0.005). Univariately, the response in retinal veins of diabetes patients correlated significantly with ganglion cell layer (GCL) thickness (r = 0.46, p = 0.010), and negatively with hemoglobin A1c (HbA1c) levels (r=-0.41, p = 0.023) and age (r=-0.38, p = 0.037), but not with baseline diameters, glucose levels, or diabetes duration. In a multiple regression model only GCL thickness (p = 0.017, β = 0.42) and HbA1c (p = 0.045, β=-0.35) remained significantly associated with the vascular flicker light response.

Conclusion: The results indicate that thinner GCL and worse glycemic control both contribute to reduced retinal neurovascular coupling in patients with clinical signs of DR. Progression of neurovascular dysfunction in DR might be related to structural degeneration of the neurovascular complex in the inner retina.

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非增殖性糖尿病视网膜病变中视网膜神经血管功能障碍与视网膜内层厚度的关系。
目的:神经血管耦合障碍和视网膜内层变薄是糖尿病患者早期可检测到的视网膜变化,两者在糖尿病视网膜病变(DR)进展过程中都会恶化。然而,迄今为止,这些特征之间的直接相互作用尚未得到研究。因此,我们旨在分析早期非增殖性糖尿病视网膜病变患者视网膜对光刺激的功能性充血反应与单个神经视网膜层厚度之间的关联:这项横断面研究纳入了 30 名患有轻度(n = 15)或中度(n = 15)非增殖性 DR 的 1 型糖尿病患者和 14 名健康受试者。使用动态血管分析仪在闪烁光照射前和照射过程中测量视网膜血管直径。通过光谱域光学相干断层扫描分析了黄斑的单层厚度:结果:与健康对照组相比,闪烁光诱导的血管扩张在患者中明显减少(静脉:3.0% 对 6.1%,P 结论:闪烁光诱导的血管扩张在患者中明显减少(静脉:3.0% 对 6.1%,P 结论):结果表明,在有临床症状的 DR 患者中,较薄的 GCL 和较差的血糖控制都会导致视网膜神经血管耦合降低。DR 神经血管功能障碍的恶化可能与视网膜内层神经血管复合体的结构退化有关。
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来源期刊
CiteScore
5.40
自引率
7.40%
发文量
398
审稿时长
3 months
期刊介绍: Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.
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