Abstract
Objective To examine the changes in retinal thickness of patients with diabetes without DR. Designs A randomization, crossover, retrospective practice. Participants 43 diabetic patients and 43 ethnic-, age-, and sex-matched controls. Methods Full retinal thicknesses of ten areas were assessed using spectral domain optical coherence tomography. Confounding variables, such as age, gender, and glycated haemoglobin (HbA1c) level, were assessed by regression analysis. Main Outcome Measures Mean retinal thickness of ten areas. Results The mean thickness of the fovea was 215.8 ± 18.9 μm in the diabetes group and 222.0 ± 18.6 μm in the control group (p = 0.04). The mean thickness of the temporal parafovea was 319.9 ± 16.7 μm in the diabetes group and 326.0 ± 14.4 μm in the control group (p = 0.01). The mean thickness of the temporal perifovea was 276.4 ± 27.9 μm in the diabetes group and 284.8 ± 17.4 μm in the control group (p = 0.02). There were no significant differences in retinal thickness between groups in other areas (p > 0.05). Regression analysis revealed that decreased retinal thickness of the temporal perifovea was associated with a higher HbA1c level (>8.7%) (p = 0.04). Conclusion and Relevance Subtle structural changes in the retina may occur in diabetes without DR. Decreased retinal thickness appeared to begin in the fovea and temporal areas. A high HbA1c level was the main factor influencing retinal thickness.
Highlights
Diabetes is a disease characterized by metabolic dysregulation
All participants underwent a comprehensive ophthalmologic examination consisting of visual acuity assessment, intraocular pressure (IOP) assessment, slit-lamp biomicroscopy combined with retinoscope, and fundus fluorescein angiography (FFA)
We examined retinal thickness in normal and type 2 diabetic individuals with no diabetic retinopathy (DR) using SD-Optical coherence tomography (OCT) and analyzed possible factors affecting retinal thickness
Summary
Diabetes is a disease characterized by metabolic dysregulation. It occurs worldwide, and the number of people with diabetes is estimated to increase dramatically from 171 million in 2000 to 366 million in 2030 [1]. It is important to detect the early signs of DR to facilitate timely monitoring and referral. Clinical features of DR are undetectable at early stages. Traditional methods for evaluating DR, including slit-lamp biomicroscopy and stereo fundus photography, are relatively insensitive to small pathological changes in the retina. Highly sensitive fluorescein angiography is invasive and not suitable for repeated examination. OCT can provide objective documentation of retinal structural changes in eyes with DR even when the changes are not evident through slitlamp biomicroscopy or angiography [5, 6]
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