Purpose: The cerebrospinal fluid pressure (CSFP) is a major determinant of central retinal vein pressure and thus of retinal capillary pressure. We tested the hypothesis whether prevalence and severity of diabetic retinopathy are associated with CSFP. Methods: The population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 +/- 9.8 years. A detailed ophthalmic examination was performed including fundus photography for the assessment of diabetic retinopathy according. Based on a previous study with lumbar cerebrospinal fluid pressure (CSFP) measurements, CSFP was calculated as CSFP[mmHg] = 0.44xBody Mass Index[kg/m(2)]+0.16 Diastolic Blood Pressure[mmHg]-0.18xAge[Years] = 1.9]. Results: In binary regression analysis, presence of diabetic retinopathy was significantly associated with higher levels of HbA1c (P<0.001; regression coefficient B:0.25; odds ratio (OR):1.28; 95% confidence interval (CI):1.15,1.43), higher blood concentration of glucose (P<0.001; B:0.40;OR:1.49;95%CI:1.36,1.63), longer known duration of diabetes mellitus (P<0.001; B:0.14;OR:1.15; 95%CI:1.11,1.19), higher systolic blood pressure (P<0.001; B:0.03;OR:1.03;95%CI:1.02,1.04), lower diastolic blood pressure (P<0.001; B:-0.06;OR:0.94;95%CI:0.91,0.97), and higher CSFP (P = 0.002; B:0.13;OR:1.14;95%CI:1.05,1.24). Severity of diabetic retinopathy was significantly associated with higher HbA1c value (P<0.001; standardized coefficient beta: 0.19; correlation coefficient B: 0.07;95%CI:0.05,0.08), higher blood concentration of glucose (P<0.001; beta:0.18;B:0.04;95%CI:0.04,0.05), longer known duration of diabetes mellitus (P<0.001; beta:0.20;B:0.03;95%CI:0.02,0.03), lower level of education (P = 0.001; beta:-0.05;B:-0.02;95%CI:-0.03,-0.01), lower diastolic blood pressure (P = 0.002; beta:-0.08;B:-0.001;95%CI:-0.004,-0.001), higher systolic blood pressure (P = 0.006; beta:0.06;B:0.001;95%CI:0.000,0.001), and higher CSFP (P = 0.006; beta:0.06;B:0.006;95%CI:0.002,0.010). Conclusions: Higher prevalence and severity of diabetic retinopathy were associated with higher estimated CSFP after adjusting for systemic parameters. Higher CSFP through a higher retinal vein pressure may lead to more marked retinal venous congestion and vascular leakage in diabetic retinae.
基金：
Chinese State Natural Sciences Fund [81170890]; National Key Technology R&D Program of the Ministry of Science and TechnologyNational Key Technology R&D Program [2012BAH05F05, 2013BAH19F04]; Deutsche ForschungsgemeinschaftGerman Research Foundation (DFG); Ruprecht-Karls-Universitat Heidelberg within the funding programme Open Access Publishing
第一作者机构：[1]Capital Med Univ, Beijing Ophthalmol & Visual Sci Key Lab, Beijing Tongren Eye Ctr, Beijing Inst Ophthalmol, Beijing, Peoples R China[2]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany
共同第一作者：
通讯作者：
通讯机构：[1]Capital Med Univ, Beijing Ophthalmol & Visual Sci Key Lab, Beijing Tongren Eye Ctr, Beijing Inst Ophthalmol, Beijing, Peoples R China[2]Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany
推荐引用方式(GB/T 7714)：
Jonas Jost B.,Wang Ningli,Xu Jie,et al.Diabetic Retinopathy and Estimated Cerebrospinal Fluid Pressure. The Beijing Eye Study 2011[J].PLOS ONE.2014,9(5):doi:10.1371/journal.pone.0096273.
APA：
Jonas, Jost B.,Wang, Ningli,Xu, Jie,Wang, Ya Xing,You, Qi Sheng...&Xu, Liang.(2014).Diabetic Retinopathy and Estimated Cerebrospinal Fluid Pressure. The Beijing Eye Study 2011.PLOS ONE,9,(5)
MLA：
Jonas, Jost B.,et al."Diabetic Retinopathy and Estimated Cerebrospinal Fluid Pressure. The Beijing Eye Study 2011".PLOS ONE 9..5(2014)
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