Associations between Local Retinal Thickness and Function in Early Diabetes

Dhamdhere, Kavita P.; Bearse, Marcus A.; Harrison, William L.; Barez, Shirin; Schneck, Marilyn E.; Adams, Anthony J.

doi:10.1167/iovs.12-10293

Cited by 26 publications

(21 citation statements)

References 25 publications

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“…42 Another recent study found that low-density lipoprotein cholesterol level corresponded with macular thickness in a group of patients with type 2 diabetes. 43 Although we did not measure macular thickness in this study, the macula can thicken as type 2 diabetes worsens, 19 which corresponds with our results.…”

Section: Discussionsupporting

confidence: 83%

“…For this analysis, only the type 2 diabetic patients were included because it has been shown in past studies that type 1 and type 2 diabetes have substantial differences in their disease profiles and retinal function. 19,20 Thus, to maximize the homogeneity of the model population, type 1 diabetic patients were excluded from this section of statistical analysis. Three factors were found to be independently associated with arteriole tortuosity after evaluation with a generalized estimating equation model (Table 3).…”

Section: Univariate Model and Correlations Between Eyesmentioning

confidence: 99%

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Arteriole Tortuosity Associated with Diabetic Retinopathy and Cholesterol

Weiler¹,

Engelke²,

Moore³

et al. 2015

Optometry and Vision Science

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First, RVT, particularly for venules, is difficult to grade consistently; therefore, future studies examining tortuosity should focus on arterioles. Second, the model indicates that there is an association between vessel changes, DR, and systemic cholesterol levels. Although DR and RVT are readily available to assess concurrently on a photograph, the addition of cholesterol to this model indicates that patients with RVT may warrant further follow-up on health factors, such as cholesterol levels.

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Section: Discussionsupporting

confidence: 83%

Section: Univariate Model and Correlations Between Eyesmentioning

confidence: 99%

Arteriole Tortuosity Associated with Diabetic Retinopathy and Cholesterol

Weiler¹,

Engelke²,

Moore³

et al. 2015

Optometry and Vision Science

View full text Add to dashboard Cite

show abstract

“…Similarly, other investigators have found reductions in NFL thickness in patients with DM, especially in the peripapillary area. 11,12 In comparing total retinal thickness between patients with DM and controls, some studies have found patients with DM to have increased foveal thickness, 3 others have found no difference, [32][33][34] and others have found overall thinning of the retina. 35 Despite these disparate results, it appears that most studies, regardless of instrumentation or method of segmentation, can localize retinal thinning to the inner retina when specific macular regions other than the fovea are measured.…”

Section: Discussionmentioning

confidence: 99%

Glucose variability and inner retinal sensory neuropathy in persons with type 1 diabetes mellitus

Stem

Dunbar

Jackson³

et al. 2016

Eye

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Purpose To quantify early neuroretinal alterations in patients with type 1 diabetes mellitus (T1DM) and to assess whether glycemic variability contributes to alterations in neuroretinal structure or function. Methods Thirty patients with T1DM and 51 controls underwent comprehensive ophthalmic examination and assessment of retinal function or structure with frequency doubling perimetry (FDP), contrast sensitivity, dark adaptation, fundus photography, and optical coherence tomography (OCT). Diabetic participants wore a subcutaneous continuous glucose monitor for 5 days, from which makers of glycemic variability including the low blood glucose index (LGBI) and area under the curve (AUC) for hypoglycemia were derived. Results Sixteen patients had no diabetic retinopathy (DR), and 14 had mild or moderate DR. Log contrast sensitivity for the DM group was significantly reduced (mean ± SD = 1.63 ± 0.06) compared with controls (1.77 ± 0.13, Po0.001). OCT analysis revealed that the inner temporal inner nuclear layer (INL) was thinner in patients with T1DM (34.9 ± 2.8 μm) compared with controls (36.5 ± 2.9 μm) (P = 0.023), although this effect lost statistical significance after application of the Bonferroni correction for multiple comparisons. Both markers of glycemic variability, the AUC for hypoglycemia (R = − 0.458, P = 0.006) and LGBI (R = − 0.473, P = 0.004), were negatively correlated with inner temporal INL thickness. Conclusions Patients with T1DM and no to moderate DR exhibit alterations in inner retinal structure and function. Increased glycemic variability correlates with retinal thinning on OCT imaging, suggesting that fluctuations in blood glucose may contribute to neurodegeneration.

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“…It is, therefore, not surprising that increased retinal thickness correlated with decreased retinal physiologic function by mfERG in most sectors. However, Dhamdhere et al 38 investigated the association between local neuroretinal function and local retinal thickness, but the correlation was not significant. In the study by Dhamdhere et al, 38 all included patients were diagnosed with diabetes but without DR, whereas the patients included in the present study were all diagnosed with relatively late-stage DR.…”

Section: Discussionmentioning

confidence: 99%