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. 2010 Jul;51(7):3660-5.
doi: 10.1167/iovs.09-5041. Epub 2010 Feb 3.

Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes

Hille W van Dijk  1 , Frank D Verbraak, Pauline H B Kok, Mona K Garvin, Milan Sonka, Kyungmoo Lee, J Hans Devries, Robert P J Michels, Mirjam E J van Velthoven, Reinier O Schlingemann, Michael D Abràmoff
Affiliations

Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes

Hille W van Dijk et al. Invest Ophthalmol Vis Sci. 2010 Jul.

Abstract

PURPOSE. To determine which retinal layers are most affected by diabetes and contribute to thinning of the inner retina and to investigate the relationship between retinal layer thickness (LT) and diabetes duration, diabetic retinopathy (DR) status, age, glycosylated hemoglobin (HbA1c), and the sex of the individual, in patients with type 1 diabetes who have no or minimal DR. METHODS. Mean LT was calculated for the individual retinal layers after automated segmentation of spectral domain-optical coherence tomography scans of patients with diabetes and compared with that in control subjects. Multiple linear regression analysis was used to determine the relationship between LT and HbA1c, age, sex, diabetes duration, and DR status. RESULTS. In patients with minimal DR, the mean ganglion cell layer (GCL) in the pericentral area was 5.1 mum thinner (95% confidence interval [CI], 1.1-9.1 mum), and in the peripheral macula, the mean retinal nerve fiber layer (RNFL) was 3.7 mum thinner (95% CI, 1.3-6.1 mum) than in the control subjects. There was a significant linear correlation (R = 0.53, P < 0.01) between GCL thickness and diabetes duration in the pooled group of patients. Multiple linear regression analysis (R = 0.62, P < 0.01) showed that DR status was the most important explanatory variable. CONCLUSIONS. This study demonstrates GCL thinning in the pericentral area and corresponding loss of RNFL thickness in the peripheral macula in patients with type 1 diabetes and no or minimal DR compared with control subjects. These results support the concept that diabetes has an early neurodegenerative effect on the retina, which occurs even though the vascular component of DR is minimal.

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Figures

Figure 1.
Figure 1.
Macular B-scan with intraretinal surfaces, as indicated by the colored lines and corresponding retinal layers. A, RNFL; B, GCL; C, IPL; D, INL; E, OPL; F, ONL+IS; G, OS; and H, RPE.
Figure 2.
Figure 2.
Correlation between pericentral GCL and peripheral RNFL thicknesses in patients with type 1 diabetes and minimal or no DR (R = 0.54, P < 0.01).
Figure 3.
Figure 3.
Correlation between GCL thickness and duration of diabetes in patients with type 1 diabetes and minimal or no DR (R = 0.53, P < 0.01).
See this image and copyright information in PMC

References

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