Abstract
Diabetic retinal neurodegeneration (DRN) has been demonstrated in eyes of patients with diabetes mellitus (DM), even in the absence of diabetic retinopathy (DR). However, no studies have looked at the rate of change in retinal layers and presence/development of DR over time per quadrant of the macula. In this longitudinal study, we aimed to clarify whether the rate of DRN is associated with the development/presence of DR within 4 different quadrants of the retina. 80 eyes of 40 patients with type 1 DM and no/minimal DR were included. At 4 visits over 6 years, SD-OCT and fundus images were acquired. Thickness of the Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Layer (GCL) and Inner Plexiform Layer (IPL) was measured in a 1-6mm circle around the fovea overall and for each quadrant (superior, nasal, inferior, temporal). Fundus images were scored for the presence/absence of DR in these areas. Multilevel analyses were performed to determine the rate of change for each layer overall and per quadrant for eyes/quadrants without and with DR during the follow-up period. RNFL and GCL showed significant thinning over time, IPL significant thickening. These changes were more pronounced for GCL and IPL in eyes/quadrants with DR during the follow-up period. RNFL and GCL both showed thinning over time, which was more pronounced in eyes with DR for GCL. This holds true even in regional parts of the retina, as quadrant analyses showed similar results, showing that structural DRN is associated with DR per quadrant independently.
Highlights
Diabetic retinopathy (DR) is one of the leading causes of low vision and blindness in the Western World [1, 2]
Retinal Nerve Fiber Layer (RNFL) and Ganglion Cell Layer (GCL) showed significant thinning over time, Inner Plexiform Layer (IPL) significant thickening. These changes were more pronounced for GCL and IPL in eyes/quadrants with DR during the follow-up period
RNFL and GCL both showed thinning over time, which was more pronounced in eyes with DR for GCL
Summary
Diabetic retinopathy (DR) is one of the leading causes of low vision and blindness in the Western World [1, 2]. One-third of the 285 million people with Diabetes Mellitus (DM) worldwide suffer from DR, and the prevalence of Diabetes Mellitus (DM) is expected to increase to about 552 million in 2030 [3]. This makes DR a serious health problem in ophthalmology, which is only expected to increase in the oncoming years [4]. Based on the interference of reflected light, a detailed cross-sectional image of the retina can be obtained [5]. This enables visualization of pathological processes such as fluid or epiretinal membranes, and permits measuring of the thickness of the retina and its layers [7]
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