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. 2020;21(11):911-920.
doi: 10.1631/jzus.B2000225.

Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy

Xiao-Hong Wu  1 , Jing-Wen Fang  2 , Yin-Qiong Huang  1 , Xue-Feng Bai  1 , Yong Zhuang  1 , Xiao-Yu Chen  1 , Xia-Hong Lin  1
Affiliations

Diagnostic value of optic disc retinal nerve fiber layer thickness for diabetic peripheral neuropathy

Xiao-Hong Wu et al. J Zhejiang Univ Sci B. 2020.

Abstract

Objective: To investigate the value of optic disc retinal nerve fiber layer (RNFL) thickness in the diagnosis of diabetic peripheral neuropathy (DPN).

Methods: Ninety patients with type 2 diabetes, including 60 patients without DPN (NDPN group) and 30 patients with DPN (DPN group), and 30 healthy participants (normal group) were enrolled. Optical coherence tomography (OCT) was used to measure the four quadrants and the overall average RNFL thickness of the optic disc. The receiver operator characteristic curve was drawn and the area under the curve (AUC) was calculated to evaluate the diagnostic value of RNFL thickness in the optic disc area for DPN.

Results: The RNFL thickness of the DPN group was thinner than those of the normal and NDPN groups in the overall average ((101.07± 12.40) µm vs. (111.07±6.99) µm and (109.25±6.90) µm), superior quadrant ((123.00±19.04) µm vs. (138.93±14.16) µm and (134.47±14.34) µm), and inferior quadrant ((129.37±17.50) µm vs. (143.60±12.22) µm and (144.48±14.10) µm), and the differences were statistically significant. The diagnostic efficiencies of the overall average, superior quadrant, and inferior quadrant RNFL thicknesses, and a combined index of superior and inferior quadrant RNFL thicknesses were similar, and the AUCs were 0.739 (95% confidence interval (CI) 0.635-0.826), 0.683 (95% CI 0.576-0.778), 0.755 (95% CI 0.652-0.840), and 0.773 (95% CI 0.672-0.854), respectively. The diagnostic sensitivity of RNFL thickness in the superior quadrant reached 93.33%.

Conclusions: The thickness of the RNFL in the optic disc can be used as a diagnostic method for DPN.

Keywords: Type 2 diabetes; Peripheral neuropathy; Retinal nerve fiber layer thickness; Optical coherence tomography; Diagnosis.

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Conflict of interest statement

Compliance with ethics guidelines: Xiao-hong WU, Jing-wen FANG, Yin-qiong HUANG, Xue-feng BAI, Yong ZHUANG, Xiao-yu CHEN, and Xia-hong LIN declare that they have no conflict of interest.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). This study was approved by the Ethics Committee of the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China. Informed consent was obtained from all patients for being included in the study.

Figures

Fig. 1
Fig. 1
Measurement of the RNFL thickness of the optic disc (a) Measurement range. S: superior quadrant; N: nasal quadrant; I: inferior quadrant; T: temporal quadrant. (b) Measurement of the RNFL thickness of the optic disc by OCT. RNFL: retinal nerve fiber layer; OCT: optical coherence tomography
Fig. 2
Fig. 2
ROC curve of DPN diagnosed by RNFL thickness of the optic disc (a) Overall average RNFL thickness; (b) Superior quadrant RNFL thickness; (c) Inferior quadrant RNFL thickness; (d) Combined index of the superior and inferior quadrant RNFL thicknesses. AUC: area under the curve; ROC: receiver operator characteristic; DPN: diabetic peripheral neuropathy; RNFL: retinal nerve fiber layer
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