Table 1_Retinal OCTA parameters and the risk of worsening kidney function in patients with type 2 diabetes: a longitudinal cohort study.docx

Exploratory mediation analysis assessed whether early eGFR slope accounted for OCTA-outcome associations.</p>Results<p>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 ± 1.38 mL/min/1.73 m²/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 = 1.02, 95% CI: 0.996-1.050).</p>Conclusions<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.</p>