Study On Visual Pathway In Patients With Type 2 Diabetic Retinopathy Based On Generalized Q-sampling Imaging

Objective In order to obtain the value of generalized Q-sampling imaging(GQI)methods for the assessment of the changes of white matter of visual pathway,applied in type 2 diabetic,to get more accurate and detailed parameters.It was hoped that this research project can provide imaging predictors for earlier intervention in type 2 diabetes mellitus.Methods From May 2020 to January 2021,56 patients with type 2 diabetes were enrolled.Among them are 31 patients without diabetic retinopathy(NDR),25 patients with diabetic retinopathy(DR)and 29 healthy controls(HC).T1-weighted 3D imaging,T2-FLAIR and diffusion imaging sequence scanning were performed respectively.The diffusion imaging sequences were reconstructed by DSI-STUDIO using GQI reconstruction algorithm.The generalized fractional anisotropy(GFA),quantitative anisotropy(QA)and normalized quantitative anisotropy(NQA)of GQI were obtained.The GFA,QA and NQA values of optic nerve,optic chiasma,optic tract and optic radiation were analyzed based on the region of interest.Double-sample independent t-test and one-way ANOVA were used to investigate the clinical indexes and GQI parameters of ROI of the case and control groups were compared.Pearson and spearman correlation test were used to analyze and correlate with the clinical features and GQI parameters.Result 1.There were no statistically significant differences in demographic data between control and T2 DM groups.Diabetic duration in DR group(9.50 ±6.41 years)was longer than that in NDR group(5.01 ± 5.14 years).2.One-way ANOVA of GQI visual conduction pathway based on ROI showed that GFA was in optic nerve,optic chiasma and optic tract,and decreased in HC group,NDR group and DR group.The GFA of the optic radiation of DR group was significantly lower than those of the HC and NDR groups,and was no significant difference between the HC and NDR groups.In optic nerve,optic chiasma,optic tract and optic radiation,there were showing significantly decreased QA and NQA in the preoperative NDR group compared with the HC group.Apparently,QA and NQA in the DR group was even more decreased than in the DR groupc.3.The correlation analysis between the average value of GQI parameter map and clinical parameters showed that the course of diabetes was negatively correlated with GFA value,QA value and NQA value,while HDL-C was positively correlated with QA value,and had no significant correlation with GFA value,NQA value.Conclusion 1.Compared with the normal control group without abnormal blood glucose,type 2 diabetic patients without diabetic retinopathy had damage to the white matter microstructure of visual conduction pathway,and the damage of related structures in patients with retinopathy was aggravated.2.GQI can quantitatively analyze the microstructure changes of white matter fibers in visual conduction pathway between patients with type 2 diabetic retinopathy and healthy people without diabetes.3.As the disease progresses and high-density lipoprotein cholesterol decreases,the damage of microstructure of white matter fiber in visual conduction pathway of diabetes was aggravated.