Abstract
Purpose To compare clinical findings, including ocular blood flow and intima-media thickness (IMT) of the carotid artery, in mild nonproliferative diabetic retinopathy (NPDR) and no diabetic retinopathy (NDR) patients, and to determine risk factors contributing to mild NPDR. Methods In 129 subjects (129 eyes) with type-2 diabetes patients and mild NPDR or NDR, standard statistical techniques were used to determine associations between clinical findings, including diabetes duration, blood levels of creatinine and hemoglobin A1c (HbA1c), central macular thickness (CMT; measured with optical coherence tomography), mean blur rate (MBR; measured with laser speckle flowgraphy), and ultrasound-measured carotid IMT. Results Diabetes duration, IMT, and CMT were significantly higher in the mild NPDR patients than the NDR patients (P=0.004, P=0.004, and P=0.003, respectively), while conversely, MBR in the overall optic nerve head (MBR-A) was lower in the mild NPDR patients. Furthermore, a logistic regression analysis showed that diabetes duration (OR, 1.11; P=0.006), diastolic blood pressure (OR, 0.93; P=0.025), heart rate (OR, 1.07; P=0.004), IMT (OR, 8.65; P=0.005), and CMT (OR, 1.03; P=0.007) were independent contributing factors to mild NPDR. Spearman's rank correlation test also showed that IMT was negatively correlated with MBR-A (P=0.011). Conclusions Increased IMT showed a close association with ocular ischemia in patients with type-2 diabetes and contributed to the presence of mild NPDR. These findings suggest that IMT may be an early biomarker of mild NPDR.
Highlights
Diabetic retinopathy (DR) is one of the most important causes of adult-onset vision loss worldwide [1]
Atherosclerosis is present in patients with type-2 diabetes that have not yet received treatment, and glucose tolerance can be impaired in these patients [10]. us, it may be promising to assess atherosclerosis as a diabetic macrovascular complication, in order to predict the occurrence of DR as a diabetic microvascular complication
The relationship between clinical findings, including intima-media thickness (IMT) and ocular blood flow parameters, in diabetes patients is still unclear. us, this study set out to determine whether systemic clinical findings, including IMT, were associated with ocular clinical findings, including measurement of the main laser speckle flowgraphy (LSFG) blood flow parameter (i.e., mean blur rate (MBR)), in type-2 diabetes patients with mild nonproliferative diabetic retinopathy (NPDR) or no diabetic retinopathy (NDR), in order to search for new, early biomarkers of mild NPDR [13]
Summary
Diabetic retinopathy (DR) is one of the most important causes of adult-onset vision loss worldwide [1]. Reduced nerve conduction velocity was recently reported to show an association with early DR in type diabetes patients [8]. Macrovascular complications, such as myocardial infarction and brain infarction due to atherosclerosis, occur simultaneously with microvascular complications, but macrovascular complications progress during the early, impaired-glucose-tolerance stage of diabetes. Us, this study set out to determine whether systemic clinical findings, including IMT, were associated with ocular clinical findings, including measurement of the main LSFG blood flow parameter (i.e., mean blur rate (MBR)), in type-2 diabetes patients with mild nonproliferative diabetic retinopathy (NPDR) or no diabetic retinopathy (NDR), in order to search for new, early biomarkers of mild NPDR [13] The relationship between clinical findings, including IMT and ocular blood flow parameters, in diabetes patients is still unclear. us, this study set out to determine whether systemic clinical findings, including IMT, were associated with ocular clinical findings, including measurement of the main LSFG blood flow parameter (i.e., mean blur rate (MBR)), in type-2 diabetes patients with mild nonproliferative diabetic retinopathy (NPDR) or no diabetic retinopathy (NDR), in order to search for new, early biomarkers of mild NPDR [13]
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