İnsülin rezistansı bulunan bireylerde retina sinir lifi tabakası kalınlığının değerlendirilmesi

Abstract

Purpose: To measure the retinal nerve fiber layer thickness (RNFLT) in prediabetic subjects who were diagnosed with insulin resistance and to compare with healthy controls. Materials and methods: Each subject was underwent a standard ophthalmological examination including measurement of best corrected visual acuity and intraocular pressure, anterior segment biomicroscopy and funduscopy. Average and four quadrant (superior, temporal, inferior, nasal) RNFLT measurements were performed using spectral domain optical coherence tomography (OCT). Plasma fasting insulin and glucose levels were noted and homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated. Results: A total of 37 patients with insulin resistance and 41 healthy controls were included in the study. Mean age of the insulin resistant group and healthy controls were 35.7±9.8 and 34.9±10.7 years, respectively. The average (95.03±11.38 µm vs 99.2±19.73 µm), inferior (119.11±18.27 µm vs 127.5±21.03 µm) and temporal (72.13±12.52 µm vs 79.2±15.97 µm) quadrant RNFL were significantly thinner in subjects with insulin resistance as compared with healthy controls (p<0.05). No significant difference was observed between the groups in the superior (121.01±9 µm vs 123.9±01 µm) and nasal (72.03±13.65 µm vs 74.52±10.52 µm) quadrants (p˃0.05). Conclusion: Neurodegeneration of the retina which is seen in diabetic patients may begin in the insulin resistance stage. OCT is a useful tool both in the early diagnosis and follow-up of retinal neurodegeneration.