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Meta-Analysis
. 2021 May;35(5):1317-1325.
doi: 10.1038/s41433-020-1020-z. Epub 2020 Jun 24.

Assessment of retinal neurodegeneration with spectral-domain optical coherence tomography: a systematic review and meta-analysis

Ziqi Tang #  1 , Ming Yan Chan #  1 , Wai Yin Leung  1 , Ho Yeung Wong  1 , Ching Man Ng  1 , Victor T T Chan  1 , Raymond Wong  1   2 , Jerry Lok  1   2 , Simon Szeto  1   2 , Jason C K Chan  1   2 , Clement C Tham  1   2 , Tien Y Wong  3 , Carol Y Cheung  4
Affiliations
Meta-Analysis

Assessment of retinal neurodegeneration with spectral-domain optical coherence tomography: a systematic review and meta-analysis

Ziqi Tang et al. Eye (Lond). 2021 May.

Abstract

Objectives: To comprehensively assess diabetic retinopathy neurodegeneration (DRN) as quantified by retinal neuronal and axonal layers measured with spectral-domain optical coherence tomography (SD-OCT) in subjects with diabetes mellitus (DM).

Methods: Articles on the topic of examining macular ganglion cell-inner plexiform layer (m-GCIPL), macular retinal nerve fibre layer (m-RNFL), macular ganglion cell complex (m-GCC), and peripapillary RNFL (p-RNFL) measured with SD-OCT in DM subjects without DR (NDR) or with non-proliferative DR (NPDR) were searched in PubMed and Embase up to November 31, 2019. Standardized mean difference (SMD) as effect size were pooled using random-effects model.

Results: Thirty-six studies searched from online databases and the CUHK DM cohort were included in the meta-analysis. In the comparison between NDR and control, macular measures including mean m-GCIPL (SMD = -0.26, p = 0.003), m-RNFL (SMD = -0.26, p = 0.046), and m-GCC (SMD = -0.28; p = 0.009) were significantly thinner in the NDR group. In the comparison between NPDR and NDR, only mean p-RNFL was significantly thinner in the NPDR group (SMD = -0.27; p = 0.03), but not other macular measures.

Conclusions: Thinning of retinal neuronal and axonal layers at macula as measured by SD-OCT are presented in eyes with NDR, supporting DRN may be the early pathogenesis in the DM patients without the presence of clinical signs of DR. In the future, these SD-OCT measures may be used as surrogates of DRN to stratify DM patients with a high risk of DR, and may be used as a therapeutic target if neuroprotection treatment for DR is available.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1. Flow chart of studies search and studies selection.
Shown exhibit the results of electronic database search and studies selection.
See this image and copyright information in PMC

References

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