title: Neuroretinal alterations in the early stages of diabetic retinopathy in patients with type 2 diabetes mellitus.
abstract: PurposeTo study neuroretinal alterations in patients affected by type 2 diabetes with no diabetic retinopathy (DR) or mild nonproliferative diabetic retinopathy (NPDR) and without any sign of diabetic macular edema.Patients and methodsIn total, 150 type 2 diabetic patients with no (131 eyes) or mild NPDR (19 eyes) and 50 healthy controls were enrolled in our study. All underwent a complete ophthalmologic examination, including Spectral-Domain optical coherence tomography (SD-OCT). Ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fiber layer (RNFL) thickness values were calculated after automated segmentation of SD-OCT scans.ResultsMean best-corrected visual acuity was 0.0±0.0 LogMAR in all the groups. Mean GC-IPL thickness was 80.6±8.1 μm in diabetic patients and 85.3±9.9 μm in healthy controls, respectively (P=0.001). Moreover, evaluating the two different diabetic groups, GC-IPL thickness was 80.7±8.1 μm and 79.7±8.8 μm in no-DR and mild-NPDR group (P=0.001 and P=0.022 compared with healthy controls, respectively). Average RNFL thickness was 86.1±10.1 μm in diabetes patients and 91.2±7.3 μm in controls, respectively (P=0.003). RNFL thickness was 86.4±10.2 μm in no-DR group and 84.1±9.4 μm in mild-NPDR group (P=0.007 and P=0.017 compared with healthy controls, respectively).ConclusionWe demonstrated a significantly reduced GC-IPL and RNFL thickness values in both no-DR and mild-NPDR groups compared with healthy controls. These data confirmed neuroretinal alterations are early in diabetes, preceding microvascular damages.
authors: Ophthalmology Clinic, Department of Medicine and Science of Ageing, High-Tech National Center in Ophthalmology, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: P
authors: P
authors: Carpineto
authors: Ophthalmology Clinic, Department of Medicine and Science of Ageing, High-Tech National Center in Ophthalmology, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: L
authors: L
authors: Toto
authors: Ophthalmology Clinic, Department of Medicine and Science of Ageing, High-Tech National Center in Ophthalmology, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: R
authors: R
authors: Aloia
authors: Ophthalmology Clinic, Department of Medicine and Science of Ageing, High-Tech National Center in Ophthalmology, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: V
authors: V
authors: Ciciarelli
authors: Ophthalmology Clinic, Department of Medicine and Science of Ageing, High-Tech National Center in Ophthalmology, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: E
authors: E
authors: Borrelli
authors: Diabetic Unit, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: E
authors: E
authors: Vitacolonna
authors: Center of Excellence on Aging and Department of Biomedical Science, University 'G. D'Annunzio' of Chieti, Laboratory of Biostatistics, Chieti, Italy.
authors: M
authors: M
authors: Di Nicola
authors: Ophthalmology Clinic, Department of Medicine and Science of Ageing, High-Tech National Center in Ophthalmology, University G. D'Annunzio Chieti-Pescara, Chieti, Italy.
authors: L
authors: L
authors: Di Antonio
authors: Ophthalmology Unit, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Verona, Italy.
authors: R
authors: R
authors: Mastropasqua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000000981:diagnostic imaging; D003930:Diabetic Retinopathy / Q000145:classification / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology*; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D012165:Retinal Ganglion Cells / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human