scholarly journals Evaluation of thickness of retinal nerve fiber layer and ganglion cell layer with inner plexiform layer in patients without diabetic retinopathy and mild diabetic retinopathy in type 2 diabetes mellitus patients using spectral-domain optical coherence tomography

2018 ◽  
Vol 6 (7) ◽  
pp. 2434
Author(s):  
Mitali Borooah ◽  
Y. Jennifer Nane ◽  
Jayant Ekka
Keyword(s):  
Diabetic Retinopathy ◽  
Ganglion Cell Layer ◽  
Plexiform Layer ◽  
Diabetic Patients ◽  
Inner Plexiform Layer ◽  
Fiber Layer ◽  
Type 2 Diabetic Patients ◽  
Rnfl Thickness ◽  
Type 2 Diabetic

Background: A widely accepted pathogenesis of DR consists of microvascular abnormalities. However recent investigations have demonstrated neurodegenerative alterations before the appearance of microvascular changes in patients with DM. Aim of the study was to evaluate thickness of retinal nerve fiber layer and ganglion cell layer with inner plexiform layer in patent without diabetic retinopathy and mild diabetic retinopathy in type 2 diabetic patients using spectral domain optical coherence tomography.Methods: Thirty patients with type 2 diabetes mellitus without diabetic retinopathy, 30 with mild diabetic retinopathy and 30 healthy controls are taken considering inclusion and exclusion criteria. GCL-ILM and RNFL thickness was measured in each individual and measurements were compared using one way ANOVA test and Pearson’s correlation was performed to evaluate the linear correlation between variables and calculated p value <0.05 was regarded as significant.Results: The average RNFL thickness was 86.18±8.44μm and 91.79±4.77μm in diabetic patients and controls respectively (p=0.002). Furthermore, for two different groups of diabetic patients, the average RNFL thickness was 86.74±11.18μm in the no DR group and 85.62±11.10μm in the mild DR group (p=0.697). The average GCL-IPL thickness was 79.95±4.32μm and 84.66±3.26μm in diabetic patients and controls, respectively (p=<0.001). Furthermore, for two different groups of diabetic patients, the average GCL-IPL thickness was 80.15±5.78μm in the no DR group and 79.75±5.70μm in the mild DR group (p=0.788).Conclusions: There was a statistically significant reduction of the mean GCL-IPL and RNFL thickness in type 2 diabetic patients with no or mild DR compared with a homogenous control group indicating neuroretinal changes occur before vascular changes of diabetic retinopathy. But the correlation of average RNFL thickness and GCL-IPL thickness was not statistically significant with the duration of diabetes and HbA1c value.

Retinal Neurovascular Changes Appear Earlier in Type 2 Diabetic Patients

2016 ◽  
Vol 27 (3) ◽  
pp. 346-351 ◽  
Author(s):  
Luisa Pierro ◽  
Lorenzo Iuliano ◽  
Maria Vittoria Cicinelli ◽  
Giuseppe Casalino ◽  
Francesco Bandello
Keyword(s):  
Early Stage ◽  
Diabetic Patients ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Type 2 Diabetic Patients ◽  
Foveal Thickness ◽  
Rnfl Thickness ◽  
Type 2 Diabetic

Purpose To investigate the early neurodegenerative changes of inner retina and choroid in type 1 and type 2 diabetic patients without retinopathy and with early-stage retinopathy. Methods In this observational cross-sectional study, 90 right eyes of 90 naive type 1 and 2 diabetic patients without diabetic retinopathy (DR) and with mild to moderate nonproliferative DR (NPDR) were analyzed. Forty healthy eyes were included as controls. We used spectral-domain optical coherence tomography to evaluate the ganglion cell complex (GCC) thickness, the retinal nerve fiber layer (RNFL) thickness, the choroid thickness, and the central foveal thickness (CFT) of patients and controls. Results Average GCC thickness turned out to be thinner in type 2 diabetic patients with no DR and with NPDR compared to controls ( p = 0.046 and p = 0.041, respectively). The RNFL thickness and CFT were similar among the studied groups and compared to controls ( p = 0.78 and p = 0.104, respectively). Average choroid thicknesses (both in the subfoveal area and in a 1-mm radius circular area) were significantly thinner in type 2 diabetic patients with no DR and NPDR, compared to DMT1 groups and controls (both p<0.0001). The GCC and choroid thickness changes were not correlated in any of the investigational groups. Conclusions Type 2 diabetic patients without retinopathy and with early-stage retinopathy have inferior thickness values of GCC and choroid compared to controls. Insulin resistance might be a possible adjunctive pathogenetic aspect of neurodegeneration.

scholarly journals Early microvascular and neuro-retinal alterations in type 2 diabetic patients without diabetic retinopathy

2020 ◽  
Author(s):  
Wei Wang ◽  
Yingfeng Zheng ◽  
Sen Liu ◽  
Yuting Li ◽  
Wenyong Huang ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Diabetic Patients ◽  
Inner Plexiform Layer ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Swept Source ◽  
Rnfl Thickness

AbstractPurposeto evaluate and correlate the alterations of microvascular and chorioretinal structure in Type 2 diabetes mellitus (T2DM) patients without clinical signs of DR.MethodsT2DM patients were randomized sampled from Guangzhou Diabetic Eye Study and healthy controls from the community of Guangzhou, China were recruited in this cross-sectional study. Demographic, clinical and ocular parameters were regularly obtained. Retinal thickness (RT), retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GC-IPL) thickness, outer retina layer (ORL) thickness and choroid thickness (CT) were automatically evaluated by swept-source optical coherence tomography (SS-OCT) in the 1, 3, and 6 mm centered on fovea. Vessel density (VD) was obtained by OCT angiography (OCTA) in the 1 and 3 mm centered on the fovea.Results1,444 eyes of 1,444 individuals (722 T2DM patients and 722 healthy controls) were included in the final analyses. Macular average RNFL was thinned (P < 0.001), average GC-IPL was thickened (P < 0.001), and ORL was thickened (P = 0.012) in DM patients compared with healthy controls independent of confounding factors. VD was significantly increased in diabetic patients without DR. Correlations were found between VD and specific layers of retina both in DM patients and in healthy controls. Especially in DM patients, average RT in positively related with parafoveal VD (β= 0.010, 95%CI: 0.003 to 0.017) and total average VD (β= 0.010,95%CI: 0.003 to 0.016). Specifically, RNFL thickness is inversely related with VD, while both GC-IPL and ORL thickness are positively related with VD in diabetic patients without DR.ConclusionThis study reports and correlates the early alterations of chorioretinal structure and retinal superficial vessels in T2DM patients even before the onset of clinical signs of DR. Findings of this study may provide novel insights to explore the pathogenesis of DR.

Male Type 2 Diabetic Patients Have Higher Diabetic Retinopathy Prevalence

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 599-P ◽  
Author(s):  
SARA CHERCHI ◽  
ALFONSO GIGANTE ◽  
PIERPAOLO CONTINI ◽  
DANILA PISTIS ◽  
ROSANGELA M. PILOSU ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Male Type ◽  
Type 2 Diabetic

Antihypertensive Drugs and Diabetic Retinopathy in Patients with Type 2 Diabetes

2015 ◽  
Vol 235 (2) ◽  
pp. 87-96
Author(s):  
Jen-Chieh Lin ◽  
Mei-Shu Lai
Keyword(s):  
Diabetic Retinopathy ◽  
Antihypertensive Drugs ◽  
Angiotensin Receptor Blockers ◽  
Incidence Rates ◽  
Diabetic Patients ◽  
Channel Blockers ◽  
Type 2 Diabetic Patients ◽  
Converting Enzyme Inhibitors ◽  
Type 2 Diabetic

Objective: To evaluate the association between the development of sight-threatening diabetic retinopathy (STDR) and antihypertensive drugs (AHDs) use among type 2 diabetic patients with concomitant hypertension. Methods: Type 2 diabetic patients aged 20-100 years who had at least one prescription for AHDs between 2000 and 2011 were identified from the Longitudinal Health Insurance Database (LHID) 2005. The incidence rates of STDR were followed and Cox proportional hazard models were used to analyze the risk associated with AHDs. Results: Users of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) were associated with a significantly higher risk than users of calcium channel blockers (CCBs), independent of baseline characteristics. After adjusting for time-varying use of concomitant medications for propensity score-matched or -unmatched cohorts, the results showed that patients receiving ACEIs/ARBs and CCBs were associated with a significantly greater risk compared with β-blocker users. Conclusions: Our study did not support a superiority of ACEIs/ARBs and CCBs over β-blockers for lowering the progression of diabetic retinopathy.

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