ABSTRACT
PURPOSE: To clarify the correlation between temporal circumpapillary retinal nerve fiber layer (RNFL) thickness and macular ganglion cell complex (mGCC) thickness in glaucomatous eyes. METHODS: Seventy-seven eyes of 77 subjects were categorized as normal, early glaucoma and moderate-to-advanced (moderate) glaucoma. After the circumpapillary RNFL thickness and mGCC thickness were measured, the temporal mean RNFL and mean mGCC were compared within the three groups. The study also investigated whether there was any correlation between the temporal RNFL and mGCC thicknesses. RESULTS: In the glaucoma groups, significant thinning of the temporal RNFL and mGCC thicknesses was noted. With the exception of the papillomacular bundle (r = -0.078), correlations were seen in each of the early glaucoma mGCC and temporal RNFL sectors (r = 0.38-0.753). Correlations were also noted for the mGCC and all temporal RNFL sectors in the moderate glaucoma group (r = 0.425-0.809). CONCLUSIONS: From the early stage of glaucoma, similar decreases of the mGCC and RNFL occured, and a high correlation existed between the two. Therefore, like RNFL, mGCC can potentially be used to detect the early stages of glaucoma. However, in early glaucoma eyes, the papillomacular bundle of the RNFL may be spared, even though mGCC thinning is present.
Subject(s)
Glaucoma/diagnosis , Nerve Fibers/pathology , Optic Disk/pathology , Optic Nerve Diseases/diagnosis , Retinal Ganglion Cells/pathology , Tomography, Optical Coherence , Female , Gonioscopy , Humans , Intraocular Pressure/physiology , Male , Microscopy, Acoustic , Middle Aged , Visual Acuity/physiology , Visual Field Tests , Visual FieldsABSTRACT
OBJECTIVE: Albuminuria can be caused by endothelial dysfunction as a result of ischemic nephropathy rather than classic diabetic nephropathy. We studied whether renal vascular resistance (resistive index [RI]) of the main renal arteries could be associated with albuminuria and further assessed the relationship between RI and aorta stiffness measured by brachial-ankle pulse-wave velocity (baPWV). RESEARCH DESIGN AND METHODS: We consecutively studied 150 patients with type 2 diabetes and the absence of clinically overt renal artery stenosis. Renal function expressed as the estimated glomerular filtration rate (eGFR) was calculated using the modified formula of modification of diet in renal disease (MDRD). The RI [(peak systolic velocity -end-diastolic velocity)/peak systolic velocity] was measured with duplex Doppler ultrasonography. RESULTS: When the presence of albuminuria (uAlb) was defined as urinary albumin-to-creatinine ratio (microg/mg x creatinine) >30, mean RI [(left RI + right RI)/2] was significantly higher in uAlb, compared with that in patients without uAlb. RI had significant associations with age (r = 0.398, P < 0.0001), diastolic blood pressure (r = -0.398, P < 0.0001), eGFR (r = -0.373, P < 0.0001), and baPWV (r = 0.223, P < 0.05), respectively. Multivariate logistic regression analysis showed that increased RI when defined as RI >0.72 (median) was significantly associated with age (P < 0.01, 95%CI 1.02-1.19), diastolic blood pressure (P < 0.01, 0.86-0.97), and uAlb (P < 0.01, 1.53-15.46), respectively. Moreover, RI was an independent risk factor for uAlb after adjustment of both diastolic blood pressure and eGFR. CONCLUSIONS: Renal vascular resistance was associated with albuminuria and aorta stiffness. Increased RI may imply the presence of any type of underlying renal damage, including ischemic nephropathy.
