Measurement of peripapillary vasculature and retinal nerve fiber layer parameters in patients with diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Li Haidong , Fang Wei , Wu Sulan ,  Shen Lijun

Eye Hospital of Wenzhou Medical University at Hangzhou, Hangzhou 310020, China;

Corresponding?author：

Shen Lijun, Email: slj@mail.eye.ac.cn

Keywords：

Diabetic retinopathy; Optic disk; Regional blood flow; Tomography, optical coherence; Retinal nerve fiber layer thickness

DOI：

10.3760/cma.j.cn511434-20190325-00113

Video：

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Objective To observe the changes of peripapillary vessel density and retinal nerve fiber layer parameters (RNFL) in diabetic mellitus (DM) patients with early diabetic retinopathy (DR).Methods A retrospective clinical study. From January to December 2018, twenty-eight DM patients (47 eyes, DM group) and 20 normal subjects (40 eyes, control group) in Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. There was no significant difference between the two groups in age (t=－1.397, P=0.169) and sex composition ratio (χ²=0.039, P=0.843). The optic nerve head was scanned by OCT angiography (OCTA) with HD 4.5 mm ×4.5 mm imaging scanning mode for all subjects. The peripapillary radial peripapillary capillaries vessel density (ppVD) and peripapillary retinal nerve fiber layer (pRNFL) thickness were measured. The changes of ppVD and pRNFL thickness between the two groups were observed. Pearson correlation analysis was used to analyze the correlation between ppVD and pRNFL in each quadrant.Results Compared with the control group, the mean ppVD and superior-hemi part, inferior-hemi part, superior, nasal, inferior and temporal quadrant ppVDs of DM group were all significantly lower than those of control group (t=5.107, 4.360, 3.713, 4.007, 2.806, 4.046, 2.214; P＜0.05). The mean and all quadrants pRNFL thickness were lower in eyes of DM group compared with the control, and the superior and inferior quadrant pRNFL thickness were statistically significant (t=2.117, 2.349; P＜0.05), while the mean pRNFL and superior-hemi, inferior-hemi part, nasal and temporal quadrant were not statistically significant (t=1.867, 1.717, 1.869, 0.720, 0.303; P＞0.05). Pearson correlation analysis showed that the significant high-positive correlation was found between ppVD and pRNFL thickness in the nasal quadrant (r=0.734, P＜0.001).Conclusion In early DR patients, ppVD decreased and pRNFL thinned.

Citation： Li Haidong, Fang Wei, Wu Sulan, Shen Lijun. Measurement of peripapillary vasculature and retinal nerve fiber layer parameters in patients with diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2020, 36(6): 458-461. doi: 10.3760/cma.j.cn511434-20190325-00113 Copy

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1. 中華醫學會糖尿病學分會. 中國2型糖尿病防治指南(2017年版)[J]. 中華糖尿病雜志, 2018, 10(1): 4-67. DOI: 10.3760/cma.j.issn.1674-5809.2018.01.003.Chinese Diabetes Society, Chinese Medical Association. Chinese guidelines for the management of type 2 diabetesmellitIls (2017)[J]. Chin J Diabet Mell, 2018, 10(1): 4-67. DOI: 10.3760/cma.j.issn.1674-5809.2018.01.003.
2. 李筱榮, 劉巨平. 重視糖尿病眼部并發癥的診斷和治療[J]. 中華實驗眼科雜志, 2017, 35(7): 577-580. DOI: 10.3760/cma.j.issn.2095-0160.2017.07.001.Li XR, Liu JP. Paying close attention to diagnosis and management of diabetic ocular complications[J]. Chin J Exp Ophthalmol, 2017, 35(7): 577-580. DOI: 10.3760/cma.j.issn.2095-0160.2017.07.001.
3. 劉芳, 李才銳, 孫曙光. 糖尿病視神經病變治療現況[J]. 中國實用眼科雜志, 2015, 33(9): 960-962. DOI: 10.3760/cma.j.issn.1006-4443.2015.09.003.Liu F, Li CR, Sun SG. Present conditions of treating diabetic optic neuropathy[J]. Chin J Prac Ophthalmol, 2015, 33(9): 960-962. DOI: 10.3760/cma.j.issn.1006-4443.2015.09.003.
4. 魏文賦, 史雪輝. 糖尿病性視神經病[M]//李筱榮, 黎曉新, 惠延年. 糖尿病眼病. 北京: 人民衛生出版社, 2010: 317-335.Wei WB, Shi XH. Diabetic optic neuropathy[M]//Li XR, Li XX, Hui YN. Diabetic ophthalmopathy. Beijing: People's Medical Publishing House, 2010: 317-335.
5. 李慧, 陳沁, 喻曉兵, 等. 糖尿病視網膜病變黃斑區血流密度和黃斑中心凹無血管區面積的變化[J]. 中華糖尿病雜志, 2017, 9(7): 435-439. DOI: 10.3760/cma.j.issn.1674-5809.2017.07.007.Li H, Chen Q, Yu XB, et al. Changes in the parafoveal and perifoveal vessel density and the area of foveal avascular zone in patients with diabetic retinopathy[J]. Chin J Diabet Mell, 2017, 9(7): 435-439. DOI: 10.3760/cma.j.issn.1674-5809.2017.07.007.
6. 鄒文軍, 武志峰, 張潔, 等. 非動脈炎性前部缺血性視神經病變患眼視盤周圍及黃斑區視網膜血流參數變化特征[J]. 中華眼視光學與視覺科學雜志, 2018, 20(12): 737-742. DOI: 10.3760/cma.j.issn.1674-845X.2018.12.007.Zhou WJ, Wu ZF, Zhang J, et al. Measurement of peripapillary and macular retinal vasculature parameters in nonarteritic anterior ischemic optic neuropathy[J]. Chin J Optom Ophthalmol Vis Sci, 2018, 20(12): 737-742. DOI: 10.3760/cma.j.issn.1674-845X.2018.12.007.
7. 中華醫學會眼科學分會眼底病學組. 我國糖尿病視網膜病變臨床診療指南(2014年)[J]. 中華眼科雜志, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.1674-5809.2014.11.004.Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association. Chinese clinical management guidelines for diabeitc retinopathy(2014)[J]. Chin J Ophthalmol, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.1674-5809.2014.11.004.
8. Ang M, Tan ACS, Cheung CMG, et al. Optical coherence tomography angiography: a review of current and future clinical applications[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(2): 237-245. DOI: 10.1007/s00417-017-3896-2.
9. 劉杏. 視乳頭和視網膜神經纖維層檢查[M]//葉天才, 王寧利. 臨床青光眼圖譜. 北京: 人民衛生出版社, 2007: 97-98.Liu X. Examination of optic papilla and retinal nerve fiber layer[M]//Ye TC, Wang NL. Clinical glaucoma atlas. Beijing: People's Medical Publishing House, 2007: 97-98.
10. Kim AY, Chu Z, Shahidzadeh A, et al. Quantifying microvascular density and morphology in diabetic retinopathy using spectral-domain optical coherence tomography angiography[J]. Invest Ophthalmol Vis Sci, 2016, 57(9): 362-370. DOI: 10.1167/iovs.15-18904.
11. Sambhav K, Abu-Amero KK, Chalam KV. Deep capillary macular perfusion indices obtained with OCT angiography correlate with degree of nonproliferative diabetic retinopathy[J]. Eur J Ophthalmol, 2017, 27(6): 716-729. DOI: 10.5301/ejo.5000948.
12. 王健, 陳松, 何廣輝, 等. 無明顯糖尿病視網膜病變的2型糖尿病患者黃斑區微血管改變的光相干斷層掃描血管成像觀察[J]. 中華眼底病雜志, 2017, 33(1): 15-18. DOI: 10.3760/cma.j.issn.1005-1015.2017.01.005.Wang J, Chen S, He GH, et al. Observation of macular microvascular changes in eyes of patients of type 2 diabetes without clinical;features of diabetic retinopathy by optical coherence tomography angiography[J]. Chin J Ocul Fundus Dis, 2017, 33(1): 15-18. DOI: 10.3760/cma.j.issn.1005-1015.2017.01.005.
13. 丁運剛, 李永平. 視網膜的解剖和組織學[M]//劉文. 臨床眼底病(內科卷). 北京: 人民衛生出版社, 2015: 5-6.Ding YG, Li YP. Anatomy and histology of retina[M]//Liu W. Clinical fundus disease (internal medicine). Beijing: People's Medical Publishing House, 2015: 5-6.
14. Chen JJ, AbouChehade JE, Iezzi R, et al. Optical coherence angiographic demonstration of retinal changes from chronic optic neuropathies[J]. Neuroophthalmology, 2017, 41(2): 76-83. DOI: 10.1080/01658107.2016.1275703.
15. Mammo Z, Heisler M, Balaratnasingam C, et al. Quantitative optical coherence tomography angiography of radial peripapillary capillaries in glaucoma, glaucoma suspect, and normal eyes[J]. Am J Ophthalmol, 2016, 170: 41-49. DOI: 10.1016/j.ajo.2016.07.015.

Chinese Journal of Ocular Fundus Diseases

Measurement of peripapillary vasculature and retinal nerve fiber layer parameters in patients with diabetic retinopathy

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