Abstract
BackgroundTo investigate the changes in retinal nerve fiber layer thickness and macular blood flow density during the preclinical stage of diabetic retinopathy and their relationship with blood glucose.MethodsIn this cross-sectional study, 97 diabetic patients (total of 188 eyes; 144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different groups based on their HbA1c levels, and they underwent optical coherence tomography angiography. We compared the optical coherence tomography angiography parameters and retinal nerve fiber layer thickness among the different glucose groups.ResultsThe parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (p < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index than the normal group. The normal group had the highest vessel density and the lowest acircularity index, followed by the no-diabetic retinopathy group and the mild non-proliferative retinopathy group, (p < 0.001). Foveal vascular density and parafoveal vessel density decreased with an increase in HbA1c. There was a negative correlation between parafoveal vessel density in the deep retinal vascular layer and fasting blood glucose (p < 0.01). The temporal retinal nerve fiber layer thickness decreased across the HbA1c level groups, and was positively correlated with the parafoveal vessel density in the superficial retinal vascular layer (p < 0.05).ConclusionsThis study shows that retinal microvasculopathy and neuropathy can be present in the absence of retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal retinal nerve fiber layer thickness was positively correlated with the vessel density of the superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists in detecting early diabetic retinal pathological lesions.
Highlights
To investigate the changes in retinal nerve fiber layer thickness and macular blood flow density during the preclinical stage of diabetic retinopathy and their relationship with blood glucose
The results showed that Systolic blood pressure (SBP) had no significant effect on the vessel density (VD) or retinal nerve fiber layer (RNFL). (Table 4) Covariance analysis, using DBP as a covariate, showed that DBP had no significant effect on blood flow density and RNFL
In this study, we analyzed the changes in macular blood flow density, foveal avascular zone (FAZ) area, and RNFL thickness of the optic disc in the normal control, no-Diabetic retinopathy (DR) and mild nonproliferative diabetic retinopathy (NPDR) groups using Optical coherence tomography angiography (OCTA), and we determined whether they were correlated with blood glucose levels
Summary
To investigate the changes in retinal nerve fiber layer thickness and macular blood flow density during the preclinical stage of diabetic retinopathy and their relationship with blood glucose. Diabetic retinopathy (DR) is a diabetes-specific microangiopathy, which is one of the main causes of blindness globally. The microangiopathy of DR may manifest as a decrease in capillary density within the macular area. The changes in the morphological area of the FAZ and the vessel density of the surrounding capillary network may reflect the degree of retinal ischemic disease. The purpose of this study was to investigate the changes in RNFL thickness of the retinal optic disc and the macular blood flow density during the preclinical stage of diabetic retinopathy and their relationship with blood glucose levels
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