Early retinal neurodegeneration in preclinical diabetic retinopathy: a multifactorial investigation

Toprak, İ̇brahim; Fenkci, Semin; Yaylalı, Güzin Fidan; Martin, Çiğdem; Yaylalı, Volkan

doi:10.1038/s41433-019-0646-1

Cited by 28 publications

(32 citation statements)

References 32 publications

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“…Although one study showed there was no signi cant changes of average or sectoral RNFL thicknesses in no-DR [30] , some other studies found RNFL loss may occur in no-DR [31,32].Our study showed that the temporal RNFL thickness in diabetic patients was signi cantly thinner than that in the normal group. Further analysis revealed that the temporal RNFL thickness in the no-DR group was signi cantly smaller than that in the normal group.…”

Section: Discussioncontrasting

confidence: 69%

Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose

Zheng

et al. 2020

Preprint

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Aim: To investigate the changes of retinal optic disc nerve fiber layer thickness and macular blood flow density in preclinical stage of diabetic retinopathy and their relationship with blood glucose. Methods: In this cross-sectional study,97 diabetic patients(total 188 eyes,144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group ) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different group by HbA1c , and underwent ocular examination by optical coherence tomography angiography. We compare optical coherence tomography angiography parameter and retinal nerve fiber layer thickness among different glucose group.Results: The parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (P < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index as compared with the normal group. From the normal group to no diabetic retinopathy group and then to mild non-proliferative retinopathy group, vessel density decreased and acircularity index increased (P < 0.001). Foveal vascular density and parafoveal vessel density decreased with the increase of HbA1c. There was a negative correlation between parafoveal vessel density of the deep retinal vascular layer and FBG (P<0.01). The temporal retinal nerve fiber layer thickness decreased among different HbA1c levels groups and was positively correlated with the parafoveal vessel density in superficial retinal vascular layer(P<0.05).Conclusions: This study shows retinal microvasculopathy and neuropathy has been present during no retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal RNFL thickness was positively correlated with the vessel density of superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists to detect early diabetic retinal pathological lesions.

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Section: Discussioncontrasting

confidence: 69%

Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose

Zheng

et al. 2020

Preprint

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“…Thinning of RNFL and GC-IPL suggests neurodegenerative changes, and it is related to diabetic retinopathy [ 28 , 29 ]. Although one study showed that there were no significant changes in the average or sectoral RNFL thicknesses in patients without DR [ 30 ], other studies found that RNFL loss may occur in patients without DR. [ 31 , 32 ] Our study showed that the temporal RNFL in diabetic patients was significantly thinner than that in the normal group. Further analysis revealed that the temporal RNFL of the no-DR group was significantly thinner than that of the normal group.…”

Section: Discussionmentioning

confidence: 64%

Early neurovascular changes in the retina in preclinical diabetic retinopathy and its relation with blood glucose

Zheng

et al. 2021

BMC Ophthalmol

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Background To investigate the changes in retinal nerve fiber layer thickness and macular blood flow density during the preclinical stage of diabetic retinopathy and their relationship with blood glucose. Methods In this cross-sectional study, 97 diabetic patients (total of 188 eyes; 144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different groups based on their HbA1c levels, and they underwent optical coherence tomography angiography. We compared the optical coherence tomography angiography parameters and retinal nerve fiber layer thickness among the different glucose groups. Results The parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (p < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index than the normal group. The normal group had the highest vessel density and the lowest acircularity index, followed by the no-diabetic retinopathy group and the mild non-proliferative retinopathy group, (p < 0.001). Foveal vascular density and parafoveal vessel density decreased with an increase in HbA1c. There was a negative correlation between parafoveal vessel density in the deep retinal vascular layer and fasting blood glucose (p < 0.01). The temporal retinal nerve fiber layer thickness decreased across the HbA1c level groups, and was positively correlated with the parafoveal vessel density in the superficial retinal vascular layer (p < 0.05). Conclusions This study shows that retinal microvasculopathy and neuropathy can be present in the absence of retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal retinal nerve fiber layer thickness was positively correlated with the vessel density of the superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists in detecting early diabetic retinal pathological lesions.

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“…Control subjects had significantly thicker values than the diabetic subjects at 1 deg temporal to the fovea and 3 deg nasal to the fovea. Disruption to the outer layers of the retina in diabetics has been previously shown [27,28].…”

Section: Plos Onementioning

confidence: 86%

“…Despite the lack of thickness differences between the control and diabetic subjects, the frequency analysis indicates that there are differences between these two groups, particularly for the domain contained between the RPE and CH boundary to the ISOS junction. This could be due to a buildup of lipids and proteins in the outer retina, potentially leading to the formation of hard exudates [28]. Molecular changes to vascular, neural, or glial tissue [1], including but not limited to vascular remodeling [6,7], are also potential sources of the frequency content differences.…”

Section: Plos Onementioning

confidence: 99%

Quantifying frequency content in cross-sectional retinal scans of diabetics vs. controls

Papay

Elsner

2021

PLoS ONE

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Purpose To examine subtle differences in the structure of diabetic vs. control retinas. Methods Spectral-domain optical coherence tomography (SD-OCT) images were compared for the retinas of 33 diabetic subjects who did not have clinical evidence of diabetic macular edema and age-matched controls, with central macular thicknesses of 275 and 276 microns, respectively. Cross-sectional retinal images through the fovea, called B-scans, were analyzed for spatial frequency content. The B-scans were processed to remove and smooth the portions of the retinal image not within regions of interest in the retina. The remaining retinal images were then quantified using a Fast Fourier Transform (FFT) approach that provided amplitude as a function of spatial frequency. Results The FFT analysis showed that diabetic retinas had spatial frequency content with significantly higher power compared to control retinas particularly for a deeper fundus layer at mid-range spatial frequencies, ranging from p = 0.0030 to 0.0497 at 16.8 to 18.2 microns/cycle. There was lower power at higher spatial frequencies, ranging from p = 0.0296 and 0.0482 at 27.4 and 29.0 microns/cycle. The range of mid-range frequencies corresponds to the sizes of small blood vessel abnormalities and hard exudates. Retinal thickness did not differ between the two groups. Conclusions Diabetic retinas, although not thicker than controls, had subtle but quantifiable pattern changes in SD-OCT images particularly in deeper fundus layers. The size range and distribution of this pattern in diabetic eyes were consistent with small blood vessel abnormalities and leakage of lipid and fluid. Feature-based biomarkers may augment retinal thickness criteria for management of diabetic eye complications, and may detect early changes.

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Early retinal neurodegeneration in preclinical diabetic retinopathy: a multifactorial investigation

Cited by 28 publications

References 32 publications

Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose

Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose

Early neurovascular changes in the retina in preclinical diabetic retinopathy and its relation with blood glucose

Quantifying frequency content in cross-sectional retinal scans of diabetics vs. controls

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