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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12.	王健, 陈松, 何广辉, 等. 无明显糖尿病视网膜病变的2型糖尿病患者黄斑区微血管改变的光相干断层扫描血管成像观察[J]. 中华眼底病杂志, 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.
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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.

1. 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 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. 李筱荣, 刘巨平. 重视糖尿病眼部并发症的诊断和治疗[J]. 中华实验眼科杂志, 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. 刘芳, 李才锐, 孙曙光. 糖尿病视神经病变治疗现况[J]. 中国实用眼科杂志, 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. 魏文赋, 史雪辉. 糖尿病性视神经病[M]//李筱荣, 黎晓新, 惠延年. 糖尿病眼病. 北京: 人民卫生出版社, 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, 陈沁, 喻晓兵, 等. 糖尿病视网膜病变黄斑区血流密度和黄斑中心凹无血管区面积的变化[J]. 中华糖尿病杂志, 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. 邹文军, 武志峰, 张洁, 等. 非动脉炎性前部缺血性视神经病变患眼视盘周围及黄斑区视网膜血流参数变化特征[J]. 中华眼视光学与视觉科学杂志, 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. 中华医学会眼科学分会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年)[J]. 中华眼科杂志, 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. 刘杏. 视乳头和视网膜神经纤维层检查[M]//叶天才, 王宁利. 临床青光眼图谱. 北京: 人民卫生出版社, 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, 陈松, 何广辉, 等. 无明显糖尿病视网膜病变的2型糖尿病患者黄斑区微血管改变的光相干断层扫描血管成像观察[J]. 中华眼底病杂志, 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. 丁运刚, 李永平. 视网膜的解剖和组织学[M]//刘文. 临床眼底病(内科卷). 北京: 人民卫生出版社, 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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