title: Selective loss of inner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy.
abstract: OBJECTIVE
  To determine whether type 1 diabetes preferentially affects the inner retinal layers by comparing the thickness of six retinal layers in type 1 diabetic patients who have no or minimal diabetic retinopathy (DR) with those of age- and sex-matched healthy controls.
  
  
  METHODS
  Fifty-seven patients with type 1 diabetes with no (n = 32) or minimal (n = 25) DR underwent full ophthalmic examination, stereoscopic fundus photography, and optical coherence tomography (OCT). After automated segmentation of intraretinal layers of the OCT images, mean thickness was calculated for six layers of the retina in the fovea, the pericentral area, and the peripheral area of the central macula and were compared with those of an age- and sex-matched control group.
  
  
  RESULTS
  In patients with minimal DR, the mean ganglion cell/inner plexiform layer was 2.7 microm thinner (95% confidence interval [CI], 2.1-4.3 microm) and the mean inner nuclear layer was 1.1 microm thinner (95% CI, 0.1-2.1 microm) in the pericentral area of the central macula compared to those of age-matched controls. In the peripheral area, the mean ganglion cell/inner plexiform layer remained significantly thinner. No other layers showed a significant difference.
  
  
  CONCLUSIONS
  Thinning of the total retina in type 1 diabetic patients with minimal retinopathy compared with healthy controls is attributed to a selective thinning of inner retinal layers and supports the concept that early DR includes a neurodegenerative component.
authors.affiliation: Department of Ophthalmology, Academic Medical Center, Amsterdam, the Netherlands. h.w.vandijk@amc.nl
authors.forename: Hille W
authors.initials: HW
authors.lastname: van Dijk
authors.forename: Pauline H B
authors.initials: PH
authors.lastname: Kok
authors.forename: Mona
authors.initials: M
authors.lastname: Garvin
authors.forename: Milan
authors.initials: M
authors.lastname: Sonka
authors.forename: J Hans
authors.initials: JH
authors.lastname: Devries
authors.forename: Robert P J
authors.initials: RP
authors.lastname: Michels
authors.forename: Mirjam E J
authors.initials: ME
authors.lastname: van Velthoven
authors.forename: Reinier O
authors.initials: RO
authors.lastname: Schlingemann
authors.forename: Frank D
authors.initials: FD
authors.lastname: Verbraak
authors.forename: Michael D
authors.initials: MD
authors.lastname: Abràmoff
mesh_terms: D000328:Adult; D000465:Algorithms; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000209:etiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010781:Photography; D012162:Retinal Degeneration / Q000175:diagnosis* / Q000209:etiology; D055351:Retinal Neurons / Q000473:pathology*; D041623:Tomography, Optical Coherence
chemical_list: D006442:Glycated Hemoglobin