Increased prelaminar tissue thickness in patients with open-angle glaucoma and type 2 diabetes.

Yoon Seop Sim,Jin-Woo Kwon,Donghyun Jee,Seung-Hyun Ko,Chan Kee Park,Jin A Choi,Andrew Anderson

doi:10.1371/journal.pone.0211641

Yoon Seop Sim, Jin-Woo Kwon + Show 5 more

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https://doi.org/10.1371/journal.pone.0211641

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Abstract

BackgroundThe characteristics of the optic nerve head (ONH) in open angle glaucoma (OAG) patients with diabetes have not been reported. This study aimed to characterize the ONH structures and glaucomatous damage in diabetic OAG patients, using age-matched non-diabetic OAG patients and control subjects.MethodsThe locations of visual field defects of OAG patients were classified and the prelaminar thickness and lamina cribrosa depth were measured in 64 OAG patients with type 2 diabetes (OAG+DM), 68 OAG patients without diabetes (OAG-DM), and 36 controls. All participants were scanned by spectral domain-optical coherence tomography. The anterior prelaminar depth and lamina cribrosa depth were measured at the center of the reference line (the Bruch’s membrane opening plane). The prelaminar tissue thickness was obtained by subtracting the anterior prelaminar depth from the anterior lamina cribrosa depth.ResultsThe visual field defects in the OAG+DM group were more commonly found in the inferior hemifield (P = 0.010), and tended to involve the central visual field compared to the OAG-DM group (P = 0.044). In the comparison of ONH parameters, the prelaminar thickness was highest in the OAG+DM group, followed by the control subjects and the OAG-DM group (P = 0.035). Post-hoc testing showed that prelaminar thickness was significantly greater in the OAG+DM group than in the OAG-DM group (P = 0.033). The lamina cribrosa depth was deepest in the OAG+DM group, followed by the OAG-DM group and the control subjects (P = 0.006).ConclusionsDiabetic and non-diabetic OAG patients exhibit different characteristics of glaucoma, particularly increased prelaminar thickening in diabetics.

Highlights

Diabetes is associated with many ocular complications
The visual field defects in the open-angle glaucoma (OAG)+DM group were more commonly found in the inferior hemifield (P = 0.010), and tended to involve the central visual field compared to the OAGDM group (P = 0.044)
In the comparison of optic nerve head (ONH) parameters, the prelaminar thickness was highest in the OAG+DM group, followed by the control subjects and the OAG-DM group (P = 0.035)

Summary

Introduction

Diabetes is associated with many ocular complications. diabetic retinopathy (DR) is the most well-known complication of diabetes, patients with diabetes may have other ocular complications such as cataract, corneal disease, glaucoma and optic disc abnormalities such as anterior ischemic optic neuropathy, and diabetic papillopathy.[1]In recently published meta-analyses, diabetes increased the prevalence of glaucoma with a relative risk of 1.48.[2]. Diabetes is associated with many ocular complications. The Rotterdam Eye Study reported that the presence of diabetes was not associated with open-angle glaucoma (OAG).[5] The ocular hypertension treatment study reached a similar conclusion, with the presence of diabetes protecting against the development of OAG, with a hazard ratio of 0.40 (0.18–0.92).[6]. The characteristics of the optic nerve head (ONH) in open angle glaucoma (OAG) patients with diabetes have not been reported. This study aimed to characterize the ONH structures and glaucomatous damage in diabetic OAG patients, using age-matched non-diabetic OAG patients and control subjects

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