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Retinal Neuronal Changes and Kidney Dysfunction in Diabetes Mellitus

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机构: [1]Singapore Natl Eye Ctr, Singapore Eye Res Inst, Singapore, Singapore [2]Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Ophthalmol,Guangdong Eye Inst, Guangzhou, Peoples R China [3]Tianjin Med Univ, Natl Clin Res Ctr Ocular Dis, Sch Optometry,Eye Dis,Eye Hosp, Tianjin Key Lab Retinal Funct & Dis,Tianjin Branch, Tianjin, Peoples R China [4]Tianjin Med Univ, Sch Optometry, Eye Hosp, Tianjin, Peoples R China [5]Johns Hopkins Univ, Sch Med, Wilmer Eye Inst, Baltimore, MD USA [6]Singapore Natl Eye Ctr, SNEC Ocular Reading Ctr, Singapore, Singapore [7]Singapore Gen Hosp, SingHealth Duke NUS Acad Med Ctr, Dept Renal Med, Singapore, Singapore [8]Natl Univ Singapore, Duke NUS Med Sch, Ophthalmol & Visual Sci Acad Clin Program, Singapore, Singapore [9]Duke NUS Med Sch, Cardiovasc & Metab Disorders Signature Res Program, Singapore, Singapore [10]Tsinghua Univ, Beijing Visual Sci & Translat Eye Res Inst BERI, Sch Clin Med, Beijing Tsinghua Changgung Hosp,Eye Ctr, Beijing, Peoples R China [11]Tsinghua Univ, Tsinghua Med, Beijing, Peoples R China
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关键词: diabetic kidney disease diabetic retinopathy estimated glomerular filtration rate optical coherence tomography outer plexiform layer

摘要:
Background: Diabetic kidney disease (DKD) and diabetic retinopathy (DR) share common microvascular pathophysiology, yet the relationship between retinal neuronal alterations and kidney dysfunction remains unclear. This cross-sectional study examines the association between individual retinal layer thickness and kidney indicators to identify novel optical coherence tomography (OCT) biomarkers for DKD. Methods: A total of 410 type 2 diabetes (T2D) patients (815 eyes) were recruited from the outpatient clinics of a tertiary eye centre in Singapore. Retinal layer thickness was measured using OCT with automated segmentation software (Orion). The association between the thickness of individual retinal layers and estimated glomerular filtration rate (eGFR) as well as urine albumin-to-creatinine ratio (UACR) categories was analysed using a Generalised Estimating Equation (GEE) approach. Results: GEE analysis identified a significant association between outer plexiform layer (OPL) thickness and both eGFR and UACR category, with perifoveal OPL thickness showing the strongest inverse association with eGFR (adjusted p = 0.0007) and positive association with the category of UACR (adjusted p = 0.005). After stratifying by retinal thickness, this association remained robust in eyes without macular oedema (foveal total retinal thickness < 320 mu m). No significant associations were found for other retinal layers. Conclusions: OPL thickening serves as a potential indicator for DKD, and OCT imaging offers a noninvasive tool for investigating retinal-renal interactions. Further longitudinal studies are needed to evaluate its utility in monitoring DKD progression.

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出版当年[2025]版:
大类 | 2 区 医学
小类 | 2 区 眼科学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 眼科学
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出版当年[2023]版:
Q1 OPHTHALMOLOGY
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Q1 OPHTHALMOLOGY

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第一作者机构: [1]Singapore Natl Eye Ctr, Singapore Eye Res Inst, Singapore, Singapore [2]Southern Med Univ, Guangdong Prov Peoples Hosp, Guangdong Acad Med Sci, Dept Ophthalmol,Guangdong Eye Inst, Guangzhou, Peoples R China
通讯作者:
通讯机构: [1]Singapore Natl Eye Ctr, Singapore Eye Res Inst, Singapore, Singapore [6]Singapore Natl Eye Ctr, SNEC Ocular Reading Ctr, Singapore, Singapore [8]Natl Univ Singapore, Duke NUS Med Sch, Ophthalmol & Visual Sci Acad Clin Program, Singapore, Singapore
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