title: Retinal ganglion cell complex changes using spectral domain optical coherence tomography in diabetic patients without retinopathy.
abstract: OBJECTIVE
  To assess the ganglion cell complex (GCC) thickness in diabetic eyes without retinopathy.
  
  
  METHODS
  Two groups included 45 diabetic eyes without retinopathy and 21 non diabetic eyes. All subjects underwent full medical and ophthalmological history, full ophthalmological examination, measuring GCC thickness and central foveal thickness (CFT) using the RTVue®spectral domain-optical coherence tomography (SD-OCT), and HbA1C level.
  
  
  RESULTS
  GCC focal loss volume (FLV%) was significantly more in diabetic eyes (22.2% below normal) than normal eyes (P=0.024). No statistically significant difference was found between the diabetic group and the control group regarding GCC global loss volume (GLV%) (P=0.160). CFT was positively correlated to the average, superior and inferior GCC (P=0.001, 0.000 and 0.001 respectively) and negatively correlated to GLV% and FLV% (P=0.002 and 0.031 respectively) in diabetic eyes. C/D ratio in diabetic eyes was negatively correlated to average, superior and inferior GCC (P=0.015, 0.007 and 0.017 respectively). The FLV% was negatively correlated to the refraction and level of HbA1c (P=0.019 and 0.013 respectively) and positively correlated to the best corrected visual acuity (BCVA) in logMAR in diabetic group (P=0.004).
  
  
  CONCLUSIONS
  Significant GCC thinning in diabetes predates retinal vasculopathy, which is mainly focal rather than diffuse. It has no preference to either the superior or inferior halves of the macula. Increase of myopic error is significantly accompanied with increased focal GCC loss. GCC loss is accompanied with increased C/D ratio in diabetic eyes.
authors.affiliation: Department of Ophthalmology, Cairo University, Kasr Alainy Faculty of Medicine Ringgold Standard Institution, Manial, Cairo 11223, Egypt.
authors.forename: Ahmed I
authors.initials: AI
authors.lastname: Hegazy
authors.affiliation: Department of Ophthalmology, Cairo University, Kasr Alainy Faculty of Medicine Ringgold Standard Institution, Manial, Cairo 11223, Egypt.
authors.forename: Rasha H
authors.initials: RH
authors.lastname: Zedan
authors.affiliation: Department of Ophthalmology, Cairo University, Kasr Alainy Faculty of Medicine Ringgold Standard Institution, Manial, Cairo 11223, Egypt.
authors.forename: Tamer A
authors.initials: TA
authors.lastname: Macky
authors.affiliation: Department of Ophthalmology, Cairo University, Kasr Alainy Faculty of Medicine Ringgold Standard Institution, Manial, Cairo 11223, Egypt.
authors.forename: Soheir M
authors.initials: SM
authors.lastname: Esmat
keywords: diabetes; ganglion cell complex; optical coherence tomography; retina