Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy
Objectives: To investigate the damage to the retinal nerve fiber layer (RNFL) and ganglion cell complex layer (GCL+) in diabetic patients without retinal microangioma and to determine the kind of nerve damage more likely to indicate early injury.Subjects and Methods: We included 360 patients (360 ey...
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doaj-efaec2f7e24d426a84c235447d6945c52020-11-25T03:39:54ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922020-09-011110.3389/fendo.2020.475672475672Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic RetinopathyXiuhua Jia0Zhijian Zhong1Tiancheng Bao2Shasha Wang3Ting Jiang4Yanling Zhang5Qigen Li6Xiang Zhu7Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Radiology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Ultrasonography, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaDepartment of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaObjectives: To investigate the damage to the retinal nerve fiber layer (RNFL) and ganglion cell complex layer (GCL+) in diabetic patients without retinal microangioma and to determine the kind of nerve damage more likely to indicate early injury.Subjects and Methods: We included 360 patients (360 eyes) with type 2 diabetes mellitus and 168 healthy volunteers (168 eyes). Patients with retinal microangioma were excluded by fundus fluorescein angiography (FFA). The parameters around the optic disc and macular area were measured by optical coherence tomography (OCT).Results: The peripapillary RNFL thickness was thinner in the temporal (72.98 ± 13.76 μm, P < 0.0001) and inferior (120.71 ± 21.43 μm, P = 0.0103) sectors in patients with no diabetic retinopathy (NDR) compared to healthy controls. The reduction of retinal thickness in the macular region was prominent in the inferior sector in patients (34.74 ± 4.92 μm, P < 0.0001) compared to normal controls. Thinning of GCL+ in the second region of the macular area was significant in patients with NDR compared to normal controls (P < 0.05). However, no difference in the GCL+ and retinal thicknesses of the central macular region was observed between the patients with NDR and healthy controls. Using the 5th percentile (P5) of normal controls as the reference value, we found that the parameters with the highest indices in patients with NDR were the inferior and temporal peripapillary RNFL thickness (13.0%), the inferior RNFL thickness in the macular area (20%), the inferior retinal thickness in the outer ring of the macular area (10.8%), and the inferior GCL+ thickness in the macular area (10.6%). The GCL+ and RNFL thicknesses in the central macular area accounted for the smallest proportion in P5 of normal controls (3%).Conclusions: Retinal nerve injury can occur in patients without retinal microangioma. The inferior RNFL in the macular area and the inferior and temporal peripapillary RNFL were most sensitive to glucose damage. These areas might be associated with early detection of diabetic retinopathy (DR) as they are more likely to indicate early damage.https://www.frontiersin.org/article/10.3389/fendo.2020.475672/fulldiabetic retinopathyoptical coherence tomographyganglion cells (GC)nerve fiber layerglycosylated hemoglobin (HbA1c)plasma glucose |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xiuhua Jia Zhijian Zhong Tiancheng Bao Shasha Wang Ting Jiang Yanling Zhang Qigen Li Xiang Zhu |
spellingShingle |
Xiuhua Jia Zhijian Zhong Tiancheng Bao Shasha Wang Ting Jiang Yanling Zhang Qigen Li Xiang Zhu Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy Frontiers in Endocrinology diabetic retinopathy optical coherence tomography ganglion cells (GC) nerve fiber layer glycosylated hemoglobin (HbA1c) plasma glucose |
author_facet |
Xiuhua Jia Zhijian Zhong Tiancheng Bao Shasha Wang Ting Jiang Yanling Zhang Qigen Li Xiang Zhu |
author_sort |
Xiuhua Jia |
title |
Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy |
title_short |
Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy |
title_full |
Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy |
title_fullStr |
Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy |
title_full_unstemmed |
Evaluation of Early Retinal Nerve Injury in Type 2 Diabetes Patients Without Diabetic Retinopathy |
title_sort |
evaluation of early retinal nerve injury in type 2 diabetes patients without diabetic retinopathy |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2020-09-01 |
description |
Objectives: To investigate the damage to the retinal nerve fiber layer (RNFL) and ganglion cell complex layer (GCL+) in diabetic patients without retinal microangioma and to determine the kind of nerve damage more likely to indicate early injury.Subjects and Methods: We included 360 patients (360 eyes) with type 2 diabetes mellitus and 168 healthy volunteers (168 eyes). Patients with retinal microangioma were excluded by fundus fluorescein angiography (FFA). The parameters around the optic disc and macular area were measured by optical coherence tomography (OCT).Results: The peripapillary RNFL thickness was thinner in the temporal (72.98 ± 13.76 μm, P < 0.0001) and inferior (120.71 ± 21.43 μm, P = 0.0103) sectors in patients with no diabetic retinopathy (NDR) compared to healthy controls. The reduction of retinal thickness in the macular region was prominent in the inferior sector in patients (34.74 ± 4.92 μm, P < 0.0001) compared to normal controls. Thinning of GCL+ in the second region of the macular area was significant in patients with NDR compared to normal controls (P < 0.05). However, no difference in the GCL+ and retinal thicknesses of the central macular region was observed between the patients with NDR and healthy controls. Using the 5th percentile (P5) of normal controls as the reference value, we found that the parameters with the highest indices in patients with NDR were the inferior and temporal peripapillary RNFL thickness (13.0%), the inferior RNFL thickness in the macular area (20%), the inferior retinal thickness in the outer ring of the macular area (10.8%), and the inferior GCL+ thickness in the macular area (10.6%). The GCL+ and RNFL thicknesses in the central macular area accounted for the smallest proportion in P5 of normal controls (3%).Conclusions: Retinal nerve injury can occur in patients without retinal microangioma. The inferior RNFL in the macular area and the inferior and temporal peripapillary RNFL were most sensitive to glucose damage. These areas might be associated with early detection of diabetic retinopathy (DR) as they are more likely to indicate early damage. |
topic |
diabetic retinopathy optical coherence tomography ganglion cells (GC) nerve fiber layer glycosylated hemoglobin (HbA1c) plasma glucose |
url |
https://www.frontiersin.org/article/10.3389/fendo.2020.475672/full |
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