Abstract
ObjectiveThis study aimed to observe vascular and neuroretinal alterations in people with prediabetes [impaired fasting glucose (IFG) and impaired glucose tolerance (IGT)] and normal glucose metabolism.MethodsA total of 21 patients with prediabetes (42 eyes) and 20 healthy controls (40 eyes) participated in our study. All patients underwent a complete eye examination [including fundus fluorescein angiography (FFA) and optical coherence tomography (OCT)] and a related general examination (complete biochemical analysis, routine blood tests, and glycosylated hemoglobin).ResultsOn FFA, no patients in either group showed any microvascular alterations. The total peripapillary retinal nerve fiber layer (pRNFL) in the prediabetic group was significantly thinner than that in the healthy control group (p < 0.0001). Only the temporal pRNFL thickness was significantly less in patients with prediabetes compared to the normal people. There was no significant difference in the thickness of retina in the range of 1 mm diameter of macular fovea (p = 0.286), but in the prediabetic group, the macular retinal thickness within the diameter of 6 mm in nasal side (p < 0.0001), superior side (p < 0.0001), temporal side (p = 0.008), and inferior side (p = 0.001) were lower than that in the control group.ConclusionIn the prediabetic group, there was no microvascular alterations, but the total pRNFL and the temporal pRNFL was significantly thinner, and the macular retinal thickness within the diameter of 6 mm in the nasal, temporal, and inferior side were lower than that in the healthy control group. These data confirm neuroretinal alterations in prediabetes prior to microvascular injury.
Highlights
Diabetes presents a heavy medical burden and increasing challenges for clinicians, both at present and in the coming decades
It is not clear whether retinal nerve damage and microangiopathy are present in prediabetes
Prediabetes patients matched in age (p = 0.15), gender (p = 0.99), best corrected visual activity (BCVA, p = 0.09), intraocular pressure (IOP, p = 0.36), spherical equivalent (p = 0.24), and axis length (p = 0.44) served as healthy controls
Summary
Diabetes presents a heavy medical burden and increasing challenges for clinicians, both at present and in the coming decades. The prevalence of elevated blood glucose levels in populations in both developed and developing countries is rising rapidly, and the absolute number of patients with prediabetes is expected to increase by approximately one-third by the middle of this century. Increasing research has indicated that diabetic retinopathy (DR) is a multitissue lesion with neural and vascular interactions. The retina is rich in vascular and neural tissue, with neurons, glial cells, and the vascular system forming a whole interdependent retinal neurovascular unit. Our previous study showed that early diabetes was associated with potential retinal nerve damage (2). It is not clear whether retinal nerve damage and microangiopathy are present in prediabetes
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