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. 2018 Fall;7(3):133-139.

Macular Inner Retinal Layer Thinning in Diabetic Patients without Retinopathy Measured by Spectral Domain Optical Coherence Tomography

Mário Pincelli Netto  1 , Verônica Castro Lima  1 , Maria Angélica Pacheco  2 , Nichard Unonius  2 , Carolina Pb Gracitelli  1 , Tiago Santos Prata  1   2
Affiliations

Macular Inner Retinal Layer Thinning in Diabetic Patients without Retinopathy Measured by Spectral Domain Optical Coherence Tomography

Mário Pincelli Netto et al. Med Hypothesis Discov Innov Ophthalmol. 2018 Fall.

Abstract

The aim of this study was to use Spectral Domain-Optical Coherence Tomography (SD-OCT) to measure the thickness of the Macular Inner Retinal Layer (MIRL) and compare the results between diabetic patients with no signs of retinopathy and healthy subjects. Overall, 47 type 2 diabetic patients without clinical signs of retinopathy were prospectively analyzed along with 36 healthy subjects. This study excluded patients with other systemic or ocular diseases. All patients had their MIRL thickness measured by RTVue-100 SD-OCT (7x7 mm macular grid). The MIRL thickness is provided by the ganglion cell complex scan (comprised of the retinal nerve fiber, ganglion cell, and inner plexiform layers). Only one eye was randomly selected if both were eligible for analysis. Mean age was similar between the two groups (diabetic patients: 57.3 ± 10.6 and control subjects: 60.2 ± 12.2 years) (P = 0.19). No significant differences regarding optic disc area and cup-to-disc ratio was observed in the comparison of the two groups (P ≥ 0.38 for both comparisons). In patients with diabetes, the average MIRL was significantly thinner when compared to controls (91.6 versus 96.2 micrometer (µm); P = 0.02). Regional analysis revealed superior and inferior MIRL to be significantly thinner in patients with diabetes than the controls (P ≤ 0.04). The juxtafoveal area was compromised (thinned) in 70% of diabetic eyes, classified as abnormal (P < 1%; compared to the device's normative database). In conclusion, patients with type 2 diabetes without clinical evidence of retinopathy had lower MIRL average values when compared to the control group. This can be explained by the ischemia and retinal tissue injury caused by diabetes even in early stages of diabetic retinopathy, which can affect MIRL thickness. Possible implications of these findings on diagnosis and treatment of diabetic retinopathy requires further investigation.

Keywords: Diabetes; Diabetic Retinopathy; Macular Inner Retinal Layer Thickness; Spectral Domain Optical Coherence.

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Conflict of interest statement

Ethical issues have been completely observed by the authors. All named authors met the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published. No conflict of interest has been presented.

Figures

Figure 1
Figure 1
Ganglion Cell Complex (GCC) Analysis Results from Three Different Patients with Diabetes Included in the Current Study.
See this image and copyright information in PMC

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