Effect of Ocular Perfusion Pressure on Incidence of Diabetic Retinopathy in Type 2 Diabetes: A Two-Year Prospective Study.

IF 2.6 3区 医学 Q2 OPHTHALMOLOGY Translational Vision Science & Technology Pub Date : 2024-10-01 DOI:10.1167/tvst.13.10.20
Yayi Yan, Xinyan Wu, Yuntong Li, Yiran Fan, Lingyi Li, Ching-Kit Tsui, Kaiqun Liu, Wenyong Huang, Xiaoling Liang, Andina Hu
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Abstract

Purpose: To investigate the association between mean ocular perfusion pressure (MOPP), estimated cerebrospinal fluid pressure (CSFP), and changes in diabetic retinopathy (DR) in a Southern Chinese population with type 2 diabetes (T2DM).

Methods: A total of 1224 subjects from the Guangzhou Diabetic Eye Study were enrolled. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and intraocular pressure (IOP) were measured. MOPP was calculated with the formula: MOPP = 2/3 [DBP + 1/3 (SBP - DBP)] - IOP. CSFP was calculated using the formula: CSFP = 0.44 × body mass index (kg/m2) + 0.16 × DBP - 0.18 × age (years) - 1.91. Incidence, progression, and regression of DR were graded based on seven-field 45° conventional fundus photographs at baseline and during two-year follow-up examinations according to the United Kingdom National Diabetic Eye Screening Program guidelines.

Results: Higher MOPP was associated with DR incidence in the multivariate model (per 1 mm Hg increase: relative risk, 1.05; 95% confidence interval, 1.01-1.09; P = 0.02) and was not associated with DR development and DR regression in two-year follow-up of T2DM patients. However, CSFP was not associated with DR changes (incidence, progression, or regression).

Conclusions: The higher MOPP is an independent risk factor for DR incidence among T2DM patients in a Southern Chinese cohort. Monitoring MOPP and managing blood pressure can be part of a comprehensive approach to prevent or delay the onset of DR in T2DM patients.

Translational relevance: MOPP might be an indicator for the detection of DR incidence.

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眼灌注压对 2 型糖尿病视网膜病变发病率的影响:一项为期两年的前瞻性研究
目的:研究华南地区2型糖尿病(T2DM)患者的平均眼灌注压(MOPP)、估计脑脊液压(CSFP)与糖尿病视网膜病变(DR)之间的关系:方法:共招募了 1224 名广州糖尿病眼研究的受试者。测量收缩压(SBP)、舒张压(DBP)和眼压(IOP)。MOPP 的计算公式为MOPP = 2/3 [DBP + 1/3 (sbp - DBP)] - IOP。CSFP 的计算公式为CSFP = 0.44 × 体重指数(kg/m2)+ 0.16 × DBP - 0.18 × 年龄(岁)- 1.91。根据英国国家糖尿病眼筛查计划指南,在基线和两年随访检查期间,根据七视野 45° 传统眼底照片对 DR 的发生、发展和消退进行分级:在多变量模型中,较高的 MOPP 与 DR 的发生率相关(每增加 1 mm Hg:相对风险为 1.05;95% 置信区间为 1.01-1.09;P = 0.02),但在对 T2DM 患者的两年随访中,较高的 MOPP 与 DR 的发展和消退无关。然而,CSFP与DR的变化(发病、进展或消退)无关:结论:在中国南方队列中,较高的 MOPP 是 T2DM 患者发生 DR 的独立危险因素。监测 MOPP 和控制血压是预防或延缓 T2DM 患者发生 DR 的综合方法的一部分:MOPP可能是检测DR发病率的一个指标。
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来源期刊
Translational Vision Science & Technology
Translational Vision Science & Technology Engineering-Biomedical Engineering
CiteScore
5.70
自引率
3.30%
发文量
346
审稿时长
25 weeks
期刊介绍: Translational Vision Science & Technology (TVST), an official journal of the Association for Research in Vision and Ophthalmology (ARVO), an international organization whose purpose is to advance research worldwide into understanding the visual system and preventing, treating and curing its disorders, is an online, open access, peer-reviewed journal emphasizing multidisciplinary research that bridges the gap between basic research and clinical care. A highly qualified and diverse group of Associate Editors and Editorial Board Members is led by Editor-in-Chief Marco Zarbin, MD, PhD, FARVO. The journal covers a broad spectrum of work, including but not limited to: Applications of stem cell technology for regenerative medicine, Development of new animal models of human diseases, Tissue bioengineering, Chemical engineering to improve virus-based gene delivery, Nanotechnology for drug delivery, Design and synthesis of artificial extracellular matrices, Development of a true microsurgical operating environment, Refining data analysis algorithms to improve in vivo imaging technology, Results of Phase 1 clinical trials, Reverse translational ("bedside to bench") research. TVST seeks manuscripts from scientists and clinicians with diverse backgrounds ranging from basic chemistry to ophthalmic surgery that will advance or change the way we understand and/or treat vision-threatening diseases. TVST encourages the use of color, multimedia, hyperlinks, program code and other digital enhancements.
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