Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2020 Sep-Oct;83(5):389-395.
doi: 10.5935/0004-2749.20200048.

Ganglion cell layer thinning in diabetic patients without retinopathy: related or unrelated to total macular thickness?

Selma A Somilleda-Ventura  1 , Dulce M Razo Blanco-Hernández  2 , Itzel Ocampo-Moreno  3 , Virgilio Lima-Gómez  3
Affiliations
Observational Study

Ganglion cell layer thinning in diabetic patients without retinopathy: related or unrelated to total macular thickness?

Selma A Somilleda-Ventura et al. Arq Bras Oftalmol. 2020 Sep-Oct.

Abstract
in English, Portuguese

Purpose: Reduction of ganglion cell layer thickness may occur in diabetic patients without retinopathy. The relationships of this preclinical finding with retinal thickness or reduced parafoveal vessel density have not been established. This study investigated the relationships of ganglion cell layer thickness with retinal thickness and parafoveal vessel density in patients with and without diabetes.

Methods: This was an observational, cross-sectional, prospective study that used optical coherence tomography angiography to compare non-diabetic patients (group 1) with diabetic patients without retinopathy (group 2). Ganglion cell layer thickness, macular thickness, and parafoveal vessel density (central, inner, and complete) medians were compared between groups (Mann-Whitney U test), and their relationships were assessed in each group (Spearman Rho test).

Results: In total, 68 eyes were included in this study: 34 in group 1 and 34 in group 2. Ganglion cell layer thickness did not differ between groups in any sector. There were strong positive correlations between fields 2 (superior parafoveal), 3 (temporal parafoveal), and 4 (inferior parafoveal) of the optical coherence tomography macular thickness map and the ganglion cell layer thickness in all sectors in both groups. Central vessel density mean was lower in diabetic patients. In group 1 alone, thickness changes in the inferior and nasal inferior ganglion cell layer sectors were partially explained by inner vessel density (r2=0.32 and r2=0.27).

Conclusions: Mean ganglion cell layer thickness was not lower in diabetic patients without retinopathy than in non-diabetic patients. Moreover, it exhibited a substantial correlation with total macular thickness. Parafoveal vessel density decreased before ganglion cell layer thinning was observed.

Objetivo: Pode ocorrer redução da espessura da camada de células ganglionares em pacientes diabéticos sem retinopatia. As relações desse achado pré-clínico com a espessura da retina ou a densidade reduzida de vasos parafoveais não foram estabelecidas. Este estudo investigou as relações da espessura da camada de células ganglionares com a espessura da retina e densidade dos vasos parafoveais em pacientes com e sem diabetes.

Métodos: Estudo prospectivo, observacional, transversal que utilizou angiotomografia de coerência óptica para comparar pacientes não diabéticos (grupo 1) com pacientes diabéticos sem retinopatia (grupo 2). As médias da espessura da camada de células ganglionares, espessura macular e densidade dos vasos parafoveais (central, interno e completo) foram comparadas entre os grupos (teste U de Mann-Whitney) e suas relações foram avaliadas em cada grupo (Teste de Spearman Rho).

Resultados: No total, 68 olhos foram incluídos neste estudo: 34 no grupo 1 e 34 no grupo 2. A espessura da camada de células ganglionares não diferiu entre os grupos em nenhum setor. Houve fortes correlações positivas entre os campos 2 (parafoveal superior), 3 (parafoveal temporal) e 4 (parafoveal inferior) do mapa da espessura macular da tomografia de coerência óptica e a espessura da camada de células ganglionares em todos os setores dos dois grupos. A média da densidade central dos vasos foi menor nos pacientes diabéticos. Somente no grupo 1, as alterações de espessura da camada de células ganglionares nos setores inferior e nasal inferior foram parcialmente explicadas pela densidade do vaso interno (r=0,32 e r=0,27).

Conclusões: A média da espessura da camada de células ganglionares não foi menor em pacientes diabéticos sem retinopatia do que em pacientes não diabéticos. Além disso, exibiu uma correlação substancial com a espessura macular total. A densidade dos vasos parafoveais diminui antes do desbaste da camada de células ganglionares.

PubMed Disclaimer

Conflict of interest statement

Disclosure of potential conflicts of interest: None of the authors has any potential conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Correlations between inferior and nasal inferior ganglion cell layer (GCL) sectors and inner vessel density in each group. A) and C) correspond to group 1, and B) and D) correspond to group 2.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Hendrick AM, Gibson MV, Kulshreshtha A. Diabetic retinopathy. Prim Care. 2015;42(3):451–464. - PubMed
    1. Verma A, Rani PK, Raman R, Pal SS, Laxmi G, Gupta M, et al. Is neuronal dysfunction an early sign of diabetic retinopathy? Microperimetry and spectral domain optical coherence tomography (SD-OCT) study in individuals with diabetes, but no diabetic retinopathy. Eye (Lond) 2009;23(9):1824–1830. - PubMed
    1. Somilleda-Ventura SA, Ceballos-Reyes GM, Lima-Gómez V. Comparison of macular retinal sensitivity and its contribution to the foveal sensitivity between diabetic and non-diabetic patients with normal visual acuity. J Optom. 2019;12(3):180–185. - PMC - PubMed
    1. Kern TS, Barber AJ. Retinal ganglion cells in diabetes. J Physiol. 2008;586(18):4401–4408. - PMC - PubMed
    1. Leung CK, Cheung CY, Weinreb RN, Qiu Q, Liu S, Li H, et al. Retinal nerve fiber layer imaging with spectral-domain optical coherence tomography: a variability and diagnostic performance study. Ophthalmology. 2009;116(7):1257–63, 1263.e1-2. - PubMed

Publication types