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. 2002 Jul;86(7):725-8.
doi: 10.1136/bjo.86.7.725.

Retinal nerve fibre layer loss in patients with type 1 diabetes mellitus without retinopathy

J M Lopes de Faria, H Russ, V P Costa

Retinal nerve fibre layer loss in patients with type 1 diabetes mellitus without retinopathy

J M Lopes de Faria et al. Br J Ophthalmol. 2002 Jul.

Abstract

Background/aim: There is evidence suggesting the occurrence of neurovisual abnormalities in patients with diabetes without retinopathy. However, the determination of abnormalities in the neural and glial elements in vivo is difficult. The aim of this study was to investigate whether a retinal nerve fibre layer (RNFL) defect (as determined by scanning laser polarimetry, SLP) is present in patients without clinical manifestations of diabetic retinopathy.

Methods: 12 patients with type 1 diabetes mellitus (DM) without retinopathy or other diabetes induced microvascular complications, underwent a complete ophthalmological examination, including automated perimetry and RNFL measurements with a nerve fibre layer analyser GDx. The data were compared with a normal control group matched for age and sex.

Results: The superior segment retardation in patients with diabetes was lower than in the control group, based on the superior integral (0.19 (SD 0.06) v 0.23 (0.04) mm(2), p=0.03) and the superior average (71.0 (11.05) v 84.27 (10.56) microm, p=0.007) parameters.

Conclusion: This finding may be indicative of significant nerve fibre loss in the superior segment of the retina in patients with type 1 diabetes mellitus but without retinopathy. The meaning of intraretinal differences in RNFL retardation, indicating asymmetric NFL loss, in patients with diabetes is yet not understood.

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Figures

Figure 1
Figure 1
(Left) The field of view was a 15° × 15° image obtained with the SLP, including a centred optic disc and the 10 × 10 pixel ellipse situated at 1.75 disc diameters from the centre of the disc. Note that the image is divided into four quadrants (superior, temporal, inferior, and nasal) by four lines originating from the centre of the optic disc. (Right) Diagram illustrating the calculation of the superior integral, which corresponds to the total area under the curve (mm2) and within the superior portion of the elliptical band surrounding the optic nerve. T = temporal, S = superior, N = nasal, I = inferior.
Figure 2
Figure 2
The individual values for the RNFL retardation measurements obtained by scanning laser polarimetry (SLP) of the superior quadrant in patients with DM and in normal controls.
See this image and copyright information in PMC

Comment in

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