German Diabetes Study – Baseline data of retinal layer thickness measured by <scp>SD</scp>‐<scp>OCT</scp> in early diabetes mellitus

Schröder, K.; Szendroedi, Julia; Benthin, Anna; Gontscharuk, Veronika; Ackermann, Philipp; Völker, Magdalena; Steingrube, Nadine; Nowotny, Bettina; Ziegler, Dan; Müssig, Karsten; Geerling, Gerd; Kuß, Oliver; Roden, Michael; Guthoff, Rainer; Cohort, Gds

doi:10.1111/aos.13851

Cited by 9 publications

(7 citation statements)

References 26 publications

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“…22 Some authors have found some level of retinal neurodegeneration, 23 although this may not always be detectable in the early stages of the disease. 24 Our study did not find any statistical differences between groups.…”

Section: Discussioncontrasting

confidence: 55%

Influence of inflammatory plasma biomarkers on choroidal thickness in type 2 diabetes mellitus

Bartol-Puyal

Isanta

Verdes³

et al. 2022

European Journal of Ophthalmology

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Purpose To assess the influence of inflammatory plasma biomarkers on choroidal thickness (CT) in patients with type 2 diabetes (T2D). Methods Cross-sectional study enrolling T2D patients and age-matched healthy controls (>55 years of age, Caucasian, axial length <26 mm, no macular edema, and naïve). Patients were examined with swept-source OCT Triton, obtaining automatic measurements. CT was analyzed using the ETDRS grid and the recently proposed choroidal division. A blood analysis was commanded: general biochemical profile, liver status, T2D status, thyroid and parathyroid activity, coagulation, general immunological profile, and inflammatory biomarkers. Results 124 eyes of 124 patients with a mean age between 66 and 68 years were examined. The new choroidal division showed differences between groups (p < 0.05) in more sectors than the ETDRS grid, and more biomarkers influenced these new sectors. T2D patients had higher levels of IL-8, TNF-α, MCP1, adiponectin and L-selectin. CT was influenced by TNF-α, IL-17, leukocytes and erythrocyte sedimentation rate, as well as by HDL cholesterol, albumin, liver function biomarkers, and TSH. HbA1c showed little influence on CT. Conclusions T2D patients present increased plasma inflammatory biomarkers, exhibiting an influence on CT. IL-17 is related to a thicker choroid but TNF-α is related to a thinner choroid. HbA1c has little influence on CT. The recently proposed choroidal division is more sensitive to CT changes than the ETDRS grid. Some sectors are more sensitive to plasma biomarkers.

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Section: Discussioncontrasting

confidence: 55%

Influence of inflammatory plasma biomarkers on choroidal thickness in type 2 diabetes mellitus

Bartol-Puyal

Isanta

Verdes³

et al. 2022

European Journal of Ophthalmology

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“…One study using optical coherence tomography (OCT) in 126 individuals with DR compared to 227 controls, showed RGC loss with increasing severity of DR leading to progressive visual loss 6. Both animal model and human studies have shown that a subpopulation of RGCs, photosensitive retinal ganglion cells (pRGCs) are affected in diabetes6–11 even though the results are conflicting 12,13…”

mentioning

confidence: 99%

Impact of Diabetic Retinopathy on Sleep, Mood, and Quality of Life

Morjaria¹,

Alexander²,

Rmj.

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Purpose Diabetic retinopathy (DR) is associated with retinal neuronal and vascular damage. DR has previously been shown to affect the photosensitive retinal ganglion cells (pRGCs). PRGCs are essential for the entrainment of circadian rhythms; thus, DR progression could lead to worsening sleep quality and mood. We investigate the relationship between increasing DR severity, and its impact on sleep quality and mood. Methods A total of 430 participants with DR, and 303 healthy controls with no ocular disease or preexisting sleep disorders were recruited. DR severity was grouped as follows: 1, mild nonproliferative (NPDR); 2, moderate/severe NPDR; and 3, proliferative diabetic retinopathy (PDR). Sleep, mood, and quality of life were assessed using the Pittsburgh Sleep Quality Index (PSQI), quality of life (SF-36), and Hospital Anxiety and Depression Score (HADS) questionnaires. Data were analyzed by severity of DR, and correlated with sleep, QOL, and mood and compared to controls. Results No significant difference between PSQI scores in the DR group or the control group was identified despite severity of DR. Mean anxiety and depression scores were within the normal range for both groups. Despite a lower general health and physical function, the DR group had lower anxiety scores than controls. Conclusions These data show that even in severe DR, sleep quality is similar to controls. However, this could be explained by the majority of individuals in this study having good visual acuities in the better eye with a residual population of pRGCs remaining unaffected by DR.

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“…While prospective studies have shown that DRN occurs before DR manifests [ 6 ], results from cross-sectional studies evaluating retinal thickness parameters to quantify DRN have reported mixed results, have included small samples and have not always controlled for the many factors that can impact thickness measurements including, age, gender, ethnicity, refractive error, cognitive impairment, glaucoma, systemic co-morbidities and medications [ 7 – 10 ]. Consequently, some studies report increased thickness of inner retinal layers, some show no changes and others suggest that the RNFL and GC-IPL may be thinner in patients with DM compared to controls [ 11 , 12 ]. Lim et al reported a higher rate of peripapillary RNFL thinning among patients with DM compared to those without DM [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Detecting retinal neurodegeneration in people with diabetes: Findings from the UK Biobank

et al. 2021

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Importance Efforts are underway to incorporate retinal neurodegeneration in the diabetic retinopathy severity scale. However, there is no established measure to quantify diabetic retinal neurodegeneration (DRN). Objective We compared total retinal, macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness among participants with and without diabetes (DM) in a population-based cohort. Design/setting/participants Cross-sectional analysis, using the UK Biobank data resource. Separate general linear mixed models (GLMM) were created using DM and glycated hemoglobin as predictor variables for retinal thickness. Sub-analyses included comparing thickness measurements for patients with no/mild diabetic retinopathy (DR) and evaluating factors associated with retinal thickness in participants with and without diabetes. Factors found to be significantly associated with DM or thickness were included in a multiple GLMM. Exposure Diagnosis of DM was determined via self-report of diagnosis, medication use, DM-related complications or glycated hemoglobin level of ≥ 6.5%. Main outcomes and measures Total retinal, mRNFL and GC-IPL thickness. Results 74,422 participants (69,985 with no DM; 4,437 with DM) were included. Median age was 59 years, 46% were men and 92% were white. Participants with DM had lower total retinal thickness (-4.57 μm, 95% CI: -5.00, -4.14; p<0.001), GC-IPL thickness (-1.73 μm, 95% CI: -1.86, -1.59; p<0.001) and mRNFL thickness (-0.68 μm, 95% CI: -0.81, -0.54; p<0.001) compared to those without DM. After adjusting for co-variates, in the GLMM, total retinal thickness was 1.99 um lower (95% CI: -2.47, -1.50; p<0.001) and GC-IPL was 1.02 μm lower (95% CI: -1.18, -0.87; p<0.001) among those with DM compared to without. mRNFL was no longer significantly different (p = 0.369). GC-IPL remained significantly lower, after adjusting for co-variates, among those with DM compared to those without DM when including only participants with no/mild DR (-0.80 μm, 95% CI: -0.98, -0.62; p<0.001). Total retinal thickness decreased 0.40 μm (95% CI: -0.61, -0.20; p<0.001), mRNFL thickness increased 0.20 μm (95% CI: 0.14, 0.27; p<0.001) and GC-IPL decreased 0.26 μm (95% CI: -0.33, -0.20; p<0.001) per unit increase in A1c after adjusting for co-variates. Among participants with diabetes, age, DR grade, ethnicity, body mass index, glaucoma, spherical equivalent, and visual acuity were significantly associated with GC-IPL thickness. Conclusion GC-IPL was thinner among participants with DM, compared to without DM. This difference persisted after adjusting for confounding variables and when considering only those with no/mild DR. This confirms that GC-IPL thinning occurs early in DM and can serve as a useful marker of DRN.

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German Diabetes Study – Baseline data of retinal layer thickness measured by SD‐OCT in early diabetes mellitus

Cited by 9 publications

References 26 publications

Influence of inflammatory plasma biomarkers on choroidal thickness in type 2 diabetes mellitus

Influence of inflammatory plasma biomarkers on choroidal thickness in type 2 diabetes mellitus

Impact of Diabetic Retinopathy on Sleep, Mood, and Quality of Life

Detecting retinal neurodegeneration in people with diabetes: Findings from the UK Biobank

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