{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:04:58Z","timestamp":1789362298941,"version":"build-2803163510"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine whether retinal optical coherence tomography angiography (OCTA) parameters are associated with subsequent worsening kidney function (WKF) in patients with type 2 diabetes (T2D) and to assess their relationship with early renal function trajectory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective cohort study, 180 patients with T2D underwent macular OCTA imaging and were followed for renal outcomes (median follow-up, 37 months). Cross-sectional associations between OCTA parameters and systemic biomarkers were examined. Multivariable Cox models adjusted for age, sex, diabetes duration, HbA1c, HDL-c, and baseline estimated glomerular filtration rate (eGFR) evaluated associations with WKF. eGFR slope over the first 12 months was estimated using linear mixed-effects models in 141 participants. Sensitivity analyses further evaluated image quality distributions, ocular comorbidities, single-eye selection, and additional adjustments for baseline renal\/hemodynamic parameters. Exploratory mediation analysis assessed whether early eGFR slope accounted for OCTA-outcome associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-two participants (23%) developed WKF. Several OCTA parameters correlated with systemic and renal biomarkers in unadjusted analyses but were not significant after multivariable adjustment. In primary adjusted Cox models, nasal inner-ring superficial vessel density (NI-SVD) was independently associated with WKF (HR, 1.10 per 1% increase; 95% CI, 1.02-1.19; p=0.013). Early eGFR slope (-1.53 \u00b1 1.38 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      \/year) was strongly associated with WKF (HR, 0.70; 95% CI, 0.54-0.89; p=0.004). NI-SVD remained significant after adjustment for early eGFR slope (HR, 1.11; 95% CI, 1.02-1.21; p=0.021). Sensitivity analyses indicated that the association between NI-SVD and WKF remained consistent with the primary analysis. Mediation analysis did not demonstrate a statistically significant indirect effect (indirect HR\u00a0=\u00a01.02, 95% CI: 0.996-1.050).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NI-SVD, a parafoveal OCTA metric was independently associated with WKF in T2D. This association was not explained by early renal functional decline, suggesting that retinal microvascular alterations are independently linked to long-term renal prognosis in T2D.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1924491","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:36:43Z","timestamp":1789360603000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Retinal OCTA parameters and the risk of worsening kidney function in patients with type 2 diabetes: a longitudinal cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Ying","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, 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