title: Abnormalities of retinal ganglion cell complex at optical coherence tomography in patients with type 2 diabetes: a sign of diabetic polyneuropathy, not retinopathy.
abstract: OBJECTIVE
  To compare optical coherence tomography (OCT)-derived neuro-retinal parameters in patients with type 2 diabetes and non-diabetic controls and to evaluate their correlation with diabetic retinopathy (DR) and polyneuropathy (DPN).
  
  
  METHODS
  One-hundred consecutive patients with type 2 diabetes were examined by spectral-domain (SD) OCT for evaluating ganglion cell complex (GCC) and retinal nerve fibre layer (RNFL) thickness and two new pattern-based quantitative measures of GCC damage, global and focal loss volume (GLV and FLV). Fifty sex- and age-matched non-diabetic subjects served as control.
  
  
  RESULTS
  RNFL thickness (101.0±10.6 vs. 106.4±10.3 μm, P=0.003) was significantly lower and GLV (6.58±4.98 vs. 4.52±3.10 %, P=0.008) and FLV (1.90±1.97 vs. 0.89±0.84 %, P<0.0001) were significantly higher in diabetic versus control subjects. The OCT parameters did not differ significantly according to DR grade. Conversely, RNFL thickness was lower and GLV and FLV were higher in patients with versus those without DPN, and the extent of changes increased significantly with quartiles of DPN score. At both bivariate and multivariate analysis, OCT parameters, especially FLV, correlated significantly with DPN measures.
  
  
  CONCLUSIONS
  The GCC is significantly affected in patients with type 2 diabetes and SD-OCT might represent a useful tool to detect DPN, but not DR in these individuals.
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Salvi
authors.affiliation: Department of NESMOS, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Vitreo-Retinal Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Plateroti
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Metabolic Fitness Association, Via Nomentana, 27 - 00015 Monterotondo Scalo Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Balducci
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Lucilla
authors.initials: L
authors.lastname: Bollanti
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Francesco G
authors.initials: FG
authors.lastname: Conti
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Vitale
authors.affiliation: Department of NESMOS, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Ophthalmology Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Santi Maria
authors.initials: SM
authors.lastname: Recupero
authors.affiliation: Department of NESMOS, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Vitreo-Retinal Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Maurizio Maurizi
authors.initials: MM
authors.lastname: Enrici
authors.affiliation: Department of NESMOS, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Vitreo-Retinal Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Fenicia
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Via di Grottarossa, 1035-1039 - 00189, Rome, Italy. Electronic address: giuseppe.pugliese@uniroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pugliese
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging* / Q000473:pathology; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D003930:Diabetic Retinopathy / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence
keywords: Diabetic polyneuropathy; Diabetic retinopathy; Ganglion cell complex; Optical coherence tomography; Type 2 diabetes