Effect of Age on Individual Retinal Layer Thickness in Normal Eyes as Measured With Spectral-Domain Optical Coherence Tomography

Demirkaya, Nazli; Dijk, Hille W. van; Schuppen, Sanne M. van; Abràmoff, Michael D.; Garvin, Mona K.; Sonka, Milan; Schlingemann, Reinier O.; Verbraak, Frank D.

doi:10.1167/iovs.13-11913

Cited by 161 publications

(202 citation statements)

References 36 publications

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“…Using these same methods, we have previously shown that, in normal subjects in the same age range without DM, the NFL thins by 0.133 μm/y parafoveally, and the GCL+IPL thins by 0.149 μm/y parafoveally (Figs. 1 and 2 and Table 1) (14). These findings confirm earlier cross-sectional findings of neuroretinal degeneration in DM, independent of DR, by our group (4, 15, 16) and others (24) and show, for the first time to our knowledge, that this loss continues over the course of the disease.…”

Section: Discussionsupporting

confidence: 91%

“…The solid and dotted red lines show the mean and 95% CI change in subjects in this study, respectively (model derived as in Table 1). Solid and dotted blue lines show the previously published mean and 95% CI loss, respectively, in normal control subjects (14). 0.29 μm/y in the GCL; thus after 10-20 y, the loss caused by RDN is similar in magnitude to that in severe glaucoma, although it may be more diffuse than the typical scotomata in glaucoma.…”

Section: Discussionmentioning

confidence: 62%

“…Pericyte loss is defined as the earliest detectable microvascular marker of DR in the retina (8), whereas microaneurysms on funduscopy or fundus photographs are defined as the first marker of clinically manifest DR (9). Socalled "preclinical diabetic retinopathy" comprises additional vascular abnormalities such as acellular capillaries (10)(11)(12)(13)(14).…”

mentioning

confidence: 99%

“…Most assume that RDN is a secondary effect of microvascular damage, but mounting evidence shows that neuroretinal alterations are present even in the absence of clinically detectable retinal vasculopathy, i.e., DR, both in donor eyes of people with DM and on retinal optical coherence tomography (OCT) image analysis (4, [14][15][16][17][18]. However, these studies were unable to show the temporal relationship between Significance Diabetic retinopathy (DR), a primary cause of blindness, is characterized by microvascular abnormalities.…”

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confidence: 99%

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Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Sohn

Dijk

Jiao

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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466

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Diabetic retinopathy (DR) has long been recognized as a microvasculopathy, but retinal diabetic neuropathy (RDN), characterized by inner retinal neurodegeneration, also occurs in people with diabetes mellitus (DM). We report that in 45 people with DM and no to minimal DR there was significant, progressive loss of the nerve fiber layer (NFL) (0.25 μm/y) and the ganglion cell (GC)/inner plexiform layer (0.29 μm/y) on optical coherence tomography analysis (OCT) over a 4-y period, independent of glycated hemoglobin, age, and sex. The NFL was significantly thinner (17.3 μm) in the eyes of six donors with DM than in the eyes of six similarly aged control donors (30.4 μm), although retinal capillary density did not differ in the two groups. We confirmed significant, progressive inner retinal thinning in streptozotocin-induced "type 1" and B6.BKS(D)-Lepr db /J "type 2" diabetic mouse models on OCT; immunohistochemistry in type 1 mice showed GC loss but no difference in pericyte density or acellular capillaries. The results suggest that RDN may precede the established clinical and morphometric vascular changes caused by DM and represent a paradigm shift in our understanding of ocular diabetic complications.diabetes | retina | neurodegeneration | diabetic retinopathy | optical coherence tomography

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 62%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Sohn

Dijk

Jiao

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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466

408

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“…Therefore, in our study the peripapillary RNFL and macular GCC thicknesses were measured by SD OCT to detect early neuronal degeneration. It is well known that RNFL and GCC thicknesses decreased with age [18,19]. As shown in Table 1, there was no significant difference with respect to age between diabetic and normal subjects.…”

Section: Discussionmentioning

confidence: 75%

Association between retinal neuronal degeneration and visual function impairment in type 2 diabetic patients without diabetic retinopathy

Zhu

et al. 2015

Sci. China Life Sci.

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The changes in retinal thickness and visual function in type 2 diabetic patients without clinical evidence of diabetic retinopathy were evaluated. A total of 141 diabetic subjects without retinopathy and 158 healthy subjects were enrolled in this study. Superior macular ganglion cell complex thicknesses were significantly decreased in diabetic cases, and no significant peripapillary retinal nerve fiber layer thickness changes were observed. The contrast sensitivities at all space frequencies were significantly different between diabetic patients and controls. The mean P50 amplitude from pattern electroretinogram results was reduced significantly in the diabetic group. In the diabetic group, average superior ganglion cell complex thicknesses positively correlated with both contrast sensitivities at high spatial frequencies and P50 amplitudes. The results indicated that ganglion cell complex thickness and visual function changes could be observed in diabetic subjects before the onset of any significant diabetic retinopathy. Macular ganglion cell complex reduction occurred much earlier than peripapillary retinal nerve fiber layer thinning in diabetic patients without retinopathy. diabetes mellitus, diabetic retinopathy, retinal nerve fiber layer, retinal ganglion cell, contrast sensitivity, electroretinogram Citation:Zhu TP, Ma J, Li YH, Zhang Z. Association between retinal neuronal degeneration and visual function impairment in type 2 diabetic patients without diabetic retinopathy. Sci China Life Sci, 2015, 58: 550 -555,

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Longitudinal Assessment of Retinal Thinning in Adults With and Without Sickle Cell Retinopathy Using Spectral-Domain Optical Coherence Tomography

et al. 2021

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IMPORTANCEDetermination of retinal thinning rates may help to identify patients who are at risk of progression of sickle cell retinopathy.OBJECTIVE To assess the rates of macular thinning in adults with and without sickle cell retinopathy using spectral-domain optical coherence tomography (OCT) and to identify ocular and systemic risk factors associated with retinal thinning. DESIGN, SETTING, AND PARTICIPANTSThis longitudinal prospective case-control study enrolled adult participants from a university-based retina subspecialty clinic between February 11, 2009, and July 3, 2019. The study was designed in autumn 2008 and conducted from February 2, 2009, to July 3, 2020. Participants with sickle cell retinopathy (sickle cell group) were matched by age and race with participants without sickle cell retinopathy (control group). Participants received annual spectral-domain OCT and clinical examinations.Those with at least 1 year of follow-up by July 3, 2020, were included in the analysis. Data were analyzed from February 2, 2009, to July 3, 2020. MAIN OUTCOMES AND MEASURESThe primary outcome was comparison of spectral-domain OCT measurements from early-treatment diabetic retinopathy study subfield rates of retinal thinning between eyes with and without sickle cell retinopathy and between different sickle cell hemoglobin subtypes. The secondary outcome was identification of ocular and systemic risk factors associated with rates of retinal thinning. RESULTS Among 370 adults (711 eyes) enrolled in the study, 310 participants (606 eyes) had sickle cell retinopathy, and 60 participants (105 eyes) did not. Of those, 175 of 310 participants (56.5%; 344 of 606 eyes [56.8%]; mean [SD] age, 37.8 [12.8] years; 126 women [72.0%]) in the sickle cell group and 31 of 60 participants (51.7%; 46 of 105 eyes [43.8%]; mean [SD] age, 59 [15.4] years; 22 women [71.0%]) in the control group had at least 1 year of clinical and spectral-domain OCT follow-up data from baseline. The mean (SD) follow-up was 53.7 (32.6) months for the sickle cell group and 54.6 (34.9) months for the control group. Rates of macular thinning in the sickle cell group were significantly higher than those in the control group for the inner nasal (difference, −1.18 μm per year; 95% CI, −1.71 to −0.65 μm per year), inner superior (difference, −1.03 μm per year; 95% CI, −1.78 to −0.29 μm per year), inner temporal (difference, −0.61 μm per year; 95% CI, −1.16 to −0.07 μm per year), and outer nasal (difference, −0.41 μm per year; 95% CI, −0.80 to −0.03 μm per year) quadrants. Patients with sickle cell hemoglobin SC and sickle cell hemoglobin β-thalassemia subtypes had higher rates of retinal thinning than those with the sickle cell hemoglobin SS subtype. Risk factors associated with greater rates of retinal thinning included participant age, stage of retinopathy, previous stroke, and presence of hypertension, acute chest syndrome, or diabetes. Hydroxyurea therapy was associated with decreased rates of retinal thinning and may be a protective factor. CONCLUSIONS AND RELEVAN...

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Effect of Age on Individual Retinal Layer Thickness in Normal Eyes as Measured With Spectral-Domain Optical Coherence Tomography

Abstract: Several macular layers and the peripapillary RNFL thickness showed significant changes correlated with age. This should be taken into consideration when analyzing macular layers and the peripapillary RNFL in SD-OCT studies of retinal diseases and glaucoma.

Cited by 161 publications

References 36 publications

Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Association between retinal neuronal degeneration and visual function impairment in type 2 diabetic patients without diabetic retinopathy

Longitudinal Assessment of Retinal Thinning in Adults With and Without Sickle Cell Retinopathy Using Spectral-Domain Optical Coherence Tomography

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