Metabolic, Microvascular, and Structural Predictors of Long-Term Functional Changes Evaluated by Multifocal Electroretinogram in Type 1 Diabetes.

IF 3.9 3区工程技术 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Biomedicines Pub Date : 2024-11-15 DOI:10.3390/biomedicines12112614

Mariacristina Parravano, Serena Fragiotta, Eliana Costanzo, Fabiana Picconi, Paola Giorno, Daniele De Geronimo, Daniela Giannini, Monica Varano, Vincenzo Parisi, Lucia Ziccardi

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Abstract

Background: This study aimed to analyze the potential pathogenic connection between metabolic factors, photoreceptor cell rearrangements, retinal microvascular perfusion, and functional parameters through multifocal electroretinography (mfERG) in type 1 diabetes mellitus (DM1).

Methods: This prospective observational cohort study enrolled DM1 patients (40.5 ± 9.1 years) with mild nonproliferative diabetic retinopathy followed for 4 years. Patients were subjected to multimodal imaging, which included color fundus photography, optical coherence tomography (OCT), OCT angiography, adaptive optics (AO), and mfERG. OCTA slabs were analyzed using ImageJ software (software version 2.3.0/1.53f) to calculate perfusion density (PD) at both superficial (SCP) and deep (DCP) capillary plexuses, as well as flow deficit percentage (FD%) at the choriocapillaris (CC). To calculate cone metrics on AO at the parafovea, including cone density (CD), linear dispersion index (LDi), and heterogeneity packing index (Hpi%) in the parafovea, the images were post-processed using a MATLAB algorithm. The mfERG P1 implicit time (IT) and N1-P1 response amplitude density (RAD) from R1 (foveal area), R2 (parafoveal area), and the unified rings R1 + R2 were evaluated.

Results: A total of 22 patients (22 eyes) were enrolled. No significant differences were noted in central mfERG amplitude and implicit time-averaged values (p > 0.05, all). The main factor influencing R1 IT was HbA1c, while R1 RAD was affected by Hpi and CC FD%. R1 + R2 IT was influenced by Hpi, LDi (p > 0.001, all), and modifications in the perfusion density in the SCP (p < 0.001) and DCP (p = 0.03) at the parafovea. In contrast, R1 + R2 RAD were associated with HbA1c (p = 0.02) and Hpi (p < 0.001).

Conclusions: Microvascular changes and glucometabolic factors are key elements influencing the long-term morphofunctional alterations at the photoreceptor level in DM1.

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通过多焦视网膜电图评估 1 型糖尿病患者长期功能变化的代谢、微血管和结构预测因素。

研究背景本研究旨在通过多焦视网膜电图（mfERG）分析1型糖尿病（DM1）患者的代谢因素、感光细胞重排、视网膜微血管灌注和功能参数之间的潜在致病联系：这项前瞻性队列观察研究对患有轻度非增生性糖尿病视网膜病变的 DM1 患者（40.5 ± 9.1 岁）进行了为期 4 年的随访。患者接受了多模态成像，包括彩色眼底照相、光学相干断层扫描（OCT）、OCT血管造影、自适应光学（AO）和mfERG。使用 ImageJ 软件（软件版本 2.3.0/1.53f）分析 OCTA 片，计算浅层（SCP）和深层（DCP）毛细血管丛的灌注密度（PD）以及绒毛膜（CC）的血流缺失百分比（FD%）。为了计算视网膜旁 AO 的视锥指标，包括视锥密度 (CD)、线性分散指数 (LDi) 和视网膜旁异质性包装指数 (Hpi%)，使用 MATLAB 算法对图像进行了后处理。评估了来自 R1（眼窝区）、R2（眼窝旁区）和 R1 + R2 统一环的 mfERG P1 隐含时间（IT）和 N1-P1 反应振幅密度（RAD）：共有 22 名患者（22 只眼睛）参加了研究。中心 mfERG 振幅和隐含时间平均值无明显差异（均 p > 0.05）。影响 R1 IT 的主要因素是 HbA1c，而 R1 RAD 则受 Hpi 和 CC FD% 的影响。R1 + R2 IT 受 Hpi、LDi（均 p > 0.001）以及视网膜旁 SCP（p < 0.001）和 DCP（p = 0.03）灌注密度变化的影响。相反，R1 + R2 RAD 与 HbA1c（p = 0.02）和 Hpi（p < 0.001）相关：结论：微血管变化和糖代谢因素是影响 DM1 患者感光器长期形态功能改变的关键因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Biomedicines Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology

CiteScore

5.20

自引率

8.50%

发文量

2823

审稿时长

8 weeks

期刊介绍： Biomedicines (ISSN 2227-9059; CODEN: BIOMID) is an international, scientific, open access journal on biomedicines published quarterly online by MDPI.