OCT is not useful for detection of minimal diabetic retinopathy in type 1 diabetes

Ciresi, Alessandro; Amato, Marco; Morreale, Daniele; Morreale, Raffaella; Giovanna, F. Di; Carita, S.; Lodato, Gaetano; Galluzzo, Aldo

doi:10.1007/s00592-010-0193-5

Cited by 15 publications

(12 citation statements)

References 24 publications

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“…Interestingly, in Ciresi et al. compared full retinal thickness of 48 patients with type 1 DM without DR and 54 with NPDR with healthy controls and did not find any difference even after a mean disease duration of 6.3 ± 6 and 15.5 ± 4 years, respectively.…”

Section: Discussionmentioning

confidence: 94%

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

Schröder

Szendroedi

Benthin

et al. 2018

Acta Ophthalmologica

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Purpose: Recent studies highlighted that early diabetic neurodegeneration is present before microvascular changes are visible. Retinal neurodegeneration can decrease retinal layer thickness. We aimed to determine whether decreased retinal layer thickness is present already in the early time course of disease. Methods: A cross-sectional analysis of patients and healthy adults from the German Diabetes Study (GDS, ClinicalTrials.gov Identifier number: CT01055093, https://clinicaltrials.gov/ct2/show/NCT01055093). Inclusion criteria were a diagnosis of diabetes mellitus (DM) within the last 12 months. Retinal layers thickness in the nasal pericentral segment was measured by spectral domain ocular coherence tomography (SD-OCT). For statistical analysis PROC MIXED (SAS-version 9.4) was used. Results: One hundred and seventy-eight eyes of 89 patients with type 1 DM (58 males, age 36 AE 11 years, BMI 25.5 AE 4.2 kg/m²) and 242 eyes of 121 patients with type 2 DM (84 males, age 53 AE 10 years, BMI 31.9 AE 6.3 kg/m²) with a disease duration of less than 1 year were compared to 76 eyes of 38 controls (27 males, age 41 AE 16 years, BMI 27.3 AE 6.4 kg/m²). Analysis of retinal layer thickness and visual function did not reveal a significant difference between patients and controls. Conclusion: In the early course of DM potential, neurodegeneration does not relate to measureable changes of retinal layer thickness.

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Section: Discussionmentioning

confidence: 94%

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

Schröder

Szendroedi

Benthin

et al. 2018

Acta Ophthalmologica

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“…A recent report by Ciresi et al questioned the clinical utility of TRT measurements to identify early DR due to the wide variability of thickness values based on retinal location and inter-patient differences(53). As our data suggests, monitoring changes in TRT alone may not provide enough information to determine significant changes due to minimal diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 99%

Nicotine Accelerates Diabetes-Induced Retinal Changes

Boretsky¹,

Gupta

Tirgan

et al. 2014

Current Eye Research

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Purpose: To investigate the effects of nicotine on retinal alterations in early stage diabetes in an established rodent model. Materials and Methods: Sprague-Dawley rats were examined using a combination of confocal scanning laser ophthalmoscopy and spectral domain optical coherence tomography to determine changes in retinal structure in response to nicotine exposure, diabetes and the combined effects of nicotine and diabetes. Diabetes was induced by a single injection of 65 mg/kg streptozotocin and nicotine injections were administered subcutaneously daily. Retinal thickness in the superior, inferior, nasal and temporal quadrants were determined based on SD-OCT volume scans (20° × 20°) centered on the optic disc. Segmentation of discrete retinal layers was performed on a subset of SD-OCT cross-sections to further examine changes in each treatment group. Survival of neurons within the ganglion cell layer (GCL) was assessed by confocal morphometric imaging. Results: The control group did not experience any significant change throughout the study. The nicotine treatment group experienced an average decrease in total retinal thickness (TRT) of 9.4 μm with the majority of the loss localized within the outer nuclear layer (ONL) as determined by segmentation analysis (P < 0.05). The diabetic group exhibited a trend toward decreased TRT while segmentation analysis of the DR group revealed significant thinning within the ONL (P < 0.05). The combination of nicotine and diabetes revealed a significant increase of 8.9 μm in the TRT (P < 0.05) accompanied by a decrease in the number of GCL neurons. Conclusions: We demonstrated significant temporal changes in retinal morphology in response to nicotine exposure, diabetes and with the combined effects of nicotine and diabetes. These findings may have implications in determining treatment strategies for diabetic patients using products containing nicotine such as cigarettes, smokeless tobacco, electronic cigarettes, or smoking cessation products.

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“…Typical lesions in progressed DR/DME such as intraretinal cystoid fluid, subretinal fluid and hyper-reflective foci are easy to detect but discreet depth changes in mild DR or subclinical stages of DR are not obvious. Earlier studies concluded that at least thickness measurements in time-domain OCT are unhelpful in early DR (Ciresi et al 2010). Today, automated algorithms, for example layer segmentation software, make quantifying the thickness of individual retinal layers and qualitatively evaluate lesions in each layer possible.…”

Section: Introductionmentioning

confidence: 99%

Ganglion cell layer thickening in well‐controlled patients with type 1 diabetes: an early sign for diabetic retinopathy?

Gerendas

Hatz

Kaider

et al. 2019

Acta Ophthalmologica

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Purpose: To evaluate early changes in retinal layers using optical coherence tomography (OCT) in patients with long-standing type 1 diabetes (DM1) receiving intensified insulin therapy. Methods: In a cross-sectional case-control study 150 patients with DM1 and 150 age-and sex-matched healthy control participants underwent OCT imaging. Scans of both eyes were analysed for different layers (NFL, GCL (+IPL), INL, outer layer complex (OLC, including OPL, ONL and ELM) and photoreceptors (PR)) in all subfields of an ETDRS grid. All analyses were performed semi-automatically using custom software by certified graders of the Vienna Reading Center. ANOVA models were used to compare the mean thickness of the layers between patients and controls. Results: Six hundred eyes with 512 datapoints in 49 b-scans in each OCT were analysed. Mean thickness in patients/controls was 31.35 lm/30.65 lm (NFL, p = 0.0347), 76.7 lm/73.15 lm (GCL, p ≤ 0.0001), 36.29 lm/37.13 lm (INL, p = 0.0116), 114.34 lm/112.02 lm (OLC, p < 0.0001) and 44.71 lm/44.69 lm (PR, p = 0.9401). When evaluating the ETDRS subfields separately for clinically meaningful hypotheses, a significant swelling of the GCL in patients could be found uniformly and a central swelling for the OLC, whereas the distribution of NFL and INL thickening suggests that their statistical significance was not clinically relevant. Conclusion: These preliminary results demonstrate that preclinical retinal changes in patients with long-standing DM1 can be found by retinal layer evaluation. However, the changes are layer-specific, with significant thickening of the GCL and less so of the OLC suggesting a role as an early sign for diffuse swelling and the evolution of DME even in well-controlled diabetes.

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OCT is not useful for detection of minimal diabetic retinopathy in type 1 diabetes

Cited by 15 publications

References 24 publications

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

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

Nicotine Accelerates Diabetes-Induced Retinal Changes

Ganglion cell layer thickening in well‐controlled patients with type 1 diabetes: an early sign for diabetic retinopathy?

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