Value of blood flow index monitoring in DR patients for RNFL thickness assessment

摘要

Objective: To explore the combined effects of hemorheology and kinetics on the thickness of the retinal nerve fiber layer (RNFL, Retinal Nerve Fiber layer) in patients with diabetic retinopathy (DR, Diabetic retinopathy). Method: From March to October 2017, 94 patients with DR and 94 healthy subjects from the First Affiliated Hospital of Changsha Medical College were selected for the current status survey. The blood rheology (Hematocrit Hct, ESR, erythrocyte deformation index DE, plasma viscosity PV, erythrocyte aggregation index AE) and hemodynamic parameters (Central Arterial Resistance Index RI, End-diastolic mean blood flow velocity EDV, Peak systolic mean flow velocity PSV) of the two groups were analyzed. Using principal components to analyze the intrinsic association of each indicator. Regression analysis method to analyze the comprehensive effects of various indicators on RNFL thickness in patients with DR. Result: Hct, ESR, DE, PV, and RI in the disease group were higher than those in the healthy group, while the EDV and PSV in the disease group were lower than those in the healthy group. The difference was statistically significant. Factor analysis was carried out for each index, and two principal components were extracted (the blood flow rheology contribution rate was 67.30％, and the hemodynamic contribution rate was 24.63％). Nasal RNFL thickness is related to Hct, ESR, PV, RI, PSV; Upper RNFL thickness is related to ESR, DE, PV, AE, EDV, PSV; RNFL thickness is related to ESR, DE, AE, RI, PSV; The thickness of RNFL below is related to DE, AE, RI, EDV, and the difference is statistically significant. Regression analysis found that the influence of 8 indicators on the RNFL thickness of patients was: PSV (OR=1.76), DE (OR=1.62), EDV (OR=1.57), RI (OR=1.33), PV (OR=1.12), AE (OR=1.03), Hct (OR=0.96), ESR (OR=0.62). Result: Hemorheology and hemodynamics have significant effects on the thickness of retinal nerve fiber layer in patients with diabetic retinopathy. The mean systolic velocity, erythrocyte deformation index, and end-diastolic mean blood flow velocity are the main influencing factors.