Abstract
To evaluate the usefulness of fundus autofluorescence imaging of diabetic patients without retinopathy to investigate early retinal damage. Fundus autofluorescence images of patients with type 2 diabetes mellitus without retinopathy (diabetic group) and age-sex matched healthy patients (control group) were recorded with a CX-1 digital mydriatic retinal camera after detailed ophthalmologic examinations. MATLAB 2013a software was used to measure the average pixel intensity and average curve width of the macula and fovea. Fifty-six eyes of 28 patients, as the diabetic group, and 54 eyes of 27 healthy patients, as the control group, were included in this study. The mean aggregation index was 168.32 ± 37.18 grayscale units (gsu) in the diabetic group and 152.27 ± 30.39 gsu in the control group (p=0.014). The mean average pixel intensity value of the fovea was 150.87 ± 35.83 gsu the in diabetic group and as 141.51 ± 31.10 gsu in the control group (p=0.060). The average curve width value was statistically higher in the diabetic group than in the control group (71.7 ± 9.2 vs. 59.4 ± 8.6 gsu, respectively, p=0.03). Fundus autofluorescence imaging analysis revealed that diabetic patients without retinopathy have significant fluorescence alterations. Therefore, a noninvasive imaging technique, such as fundus autofluorescence, may be valuable for evaluation of the retina of diabetic patients without retinopathy.
Highlights
Diabetes mellitus (DM) is a common systemic disease with microvascular pathology that can cause visual loss unless diagnosed and treated early[1,2]
The diabetic group consisted of 12 males and 16 females with a mean age of 57.38 ± 8.28 years, while the control group was comprised of 12 males and 15 females with a mean age of 58.26 ± 8.65 years
DM is a common systemic disease characterized by microvascular damage, caused by oxidative stress, polyol accumulation, advanced glycation end products, activation of protein kinase-c and caspase 3, mitochondrial damage, and apoptosis of the retinal pericytes and endothelial cells[2,12,13]
Summary
Diabetes mellitus (DM) is a common systemic disease with microvascular pathology that can cause visual loss unless diagnosed and treated early[1,2]. Fluorescence is the term in which certain light-excited molecules of a given wavelength emit light at longer wavelengths. Many studies in the literature report that DR and diabetic macular edema cause hyperautofluorescence in FAF imaging due to the increased amount of lipofuscin and decreased amount of lutein and zeaxanthin[7,8,10,11]. To the best of our knowledge, no study has yet to evaluate FAF imaging of diabetic patients without retinopathy
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