TY - JOUR
TI - Peripapillary Retinal Nerve Fiber Layer Changes in Patients with
Diabetes Mellitus: A Case-control Study
AU - Chatziralli, Irini
AU - Karamaounas, Aristotelis
AU - Dimitriou, Eleni and
AU - Kazantzis, Dimitrios
AU - Theodossiadis, George
AU - Kozobolis, Vassilios
AU - and Theodossiadis, Panagiotis
JO - Seminars in Ophthalmology
PY - 2020
VL - 35
TODO - 4
SP - 257-260
PB - Taylor and Francis Inc.
SN - 0882-0538, 1744-5205
TODO - 10.1080/08820538.2020.1810289
TODO - RNFL; diabetes; HbA1c; retinopathy; controls
TODO - Purpose To evaluate peripapillary retinal nerve fiber layer (RNFL)
changes in patients with diabetes mellitus (DM) and compare them with
those of normal population. In addition, this study aims to determine
potential factors, affecting RNFL changes in patients with DM. Methods
Participants in this study were 107 patients (211 eyes) with DM and 100
healthy controls (200 eyes). Diabetic patients were further classified
into four groups depending on severity of diabetic retinopathy (no
retinopathy, mild, moderate, severe nonproliferative diabetic
retinopathy, and proliferative diabetic retinopathy, while presence of
macular edema was also assessed. All participants underwent
spectral-domain optical coherence tomography (SD-OCT) to measure RNFL
thickness, while demographic and clinical characteristics of the
participants were also recorded. Results Patients with DM with or
without DR presented significantly decreased peripapillary RNFL
thickness in all quadrants. In the diabetic group, the multivariate
analysis showed a significant association between decreased average RNFL
thickness and increased HbA1c (p< 0.001), longer DM duration (p= 0.007),
and more severe diabetic retinopathy status (p= 0.016), while presence
of DME, age, gender, hypertension, and hyperlipidemia were not found to
be associated with RNFL thickness decrease. Conclusion Diabetes mellitus
seems to affect RNFL thickness, suggesting that early neurodegenerative
changes may occur, potentially before microvascular alterations. Since
duration of disease, DR severity, and HbA1c levels were associated with
RNFL thinning, modifying glycemic control seems to be important to
potentially prevent the development of DM complications.
ER -