Abstract
Background: We aimed to measure and correlate inner retinal layer (IRL) thickness and macular sensitivity by optical coherence tomography (OCT) and by microperimetry, respectively, in type 1 diabetes mellitus patients (DM1) without diabetic retinopathy (DR). Methods: Fifty-one DM1 patients and 81 age-matched healthy subjects underwent measurement of the axial length (AL), retinal thickness in the macular ETDRS areas by swept source (SS)-OCT and macular sensitivity by microperimeter. Results: The total retinal and IRL thicknesses were thicker in the DM1 group (p < 0.05) in practically all ETDRS areas, and they had a generalized decrease in sensitivity (p < 0.05) in 9 areas between both groups. There was a significant negative correlation between retinal sensitivity and age in all areas and in visual acuity (VA) in 5 out of the 9 areas for DM1 patients. Only a mild negative correlation was observed between retinal sensitivity in the 5° nasal inner (5NI) area and in IRL thickness in the temporal inner (TI) area (−0.309 with p = 0.029) in the DM1 group. Conclusion: Aging and disease evolution in DM1 patients without DR signs generate a decrease in retinal sensitivity. There was a direct relationship between retinal sensitivity and macular thickness in the DM1 group.
Highlights
Diabetic retinopathy (DR) is regarded mainly as a microvascular disorder [1], there is evidence that supports the appearance of functional changes in early stages [2,3]
A total of 132 eyes were analyzed, of which 51 belonged to 51 DM1 patients (46.2% women and 53.8% men) with an average disease evolution of 25.88 ± 8.42 years and without diabetic retinopathy (DR) signs, while 81 eyes corresponded to 81 healthy subjects (54% women and 46% men) without statistically significant differences between the gender (p = 0.371)
In the anatomo-functional study, we found a negative correlation between visual acuity (VA) and retinal sensitivity (Table 3) since good VA depends on correct retinal neuron function [30]
Summary
Diabetic retinopathy (DR) is regarded mainly as a microvascular disorder [1], there is evidence that supports the appearance of functional changes in early stages [2,3]. It suggests that prior to the appearance of DR, there is neurodegeneration that causes functional [4,5] and structural abnormalities [6,7], such as a decrease in retinal sensitivity detectable by microperimetry [8,9,10] or changes in macular thickness seen on optical coherence tomography (OCT) [11,12]. We aimed to measure and correlate inner retinal layer (IRL) thickness and macular sensitivity by optical coherence tomography (OCT) and by microperimetry, respectively, in type 1 diabetes mellitus patients (DM1) without diabetic retinopathy (DR). Results: The total retinal and IRL thicknesses were thicker in the DM1 group (p < 0.05) in practically all ETDRS areas, and they had a generalized decrease in sensitivity (p < 0.05) in 9 areas between both groups. There was a direct relationship between retinal sensitivity and macular thickness in the DM1 group
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