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Structural neurodegeneration correlates with early diabetic retinopathy

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Abstract

Purpose

To examine differences in structural and functional neurodegenerative measurements between patients with no and early diabetic retinopathy (DR).

Methods

In this cross-sectional study, we examined 103 patients with type 2 diabetes mellitus. In 7-field fundus photographs acquired with Topcon TRC-NW6S, a single, certified grader determined the presence of DR according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Retinal neurodegeneration was evaluated by Topcon 3D OCT-2000 spectral domain optical coherence tomography (OCT) and by a RETI-scan multifocal electroretinography (mf-ERG) system in rings 1–6.

Results

Median age and duration of diabetes were 63.6 and 10 years, respectively, and 46% were men. Median HbA1c was 50 mmol/mol (6.7%), and ETDRS levels were 10 (41.7%, n = 43), 20 (35.0%, n = 36), and 35 (23.3%, n = 24). The duration of diabetes increased with higher levels of DR (p = 0.04), but patients with different level of DR did not differ according to age, sex, blood pressure, HbA1c, and mf-ERG or OCT parameters. In a multiple logistic regression model, macular ganglion cell layer thickness was associated with the presence of DR (OR 1.73 per 5 μm increase, 95% CI 1.06–2.85, p = 0.03). Conversely, retinal nerve fibre layer thickness at optic disc was inversely related to DR (OR 0.69 per 5 μm increase, 95% CI 0.51–0.95, p = 0.02). There were no associations between DR and mf-ERG outcomes.

Conclusion

In patients with type 2 diabetes, structural neurogenic characteristics were associated with DR. If confirmed by larger prospective studies, these results may indicate that a complex neurovascular interaction is an early event in the pathogenesis of DR.

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Acknowledgements

This work was supported by Fight for Sight Denmark, King Christian X Foundation, the Region of Southern Denmark, and University of Southern Denmark.

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Authors and Affiliations

  1. Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark

    Ulrik Frydkjaer-Olsen, Rasmus Soegaard Hansen & Jakob Grauslund

  2. Department of Clinical Research, University of Southern Denmark, Odense, Denmark

    Ulrik Frydkjaer-Olsen, Rasmus Soegaard Hansen, Tunde Peto & Jakob Grauslund

  3. Queen’s University Belfast, Belfast, UK

    Tunde Peto

Authors
  1. Ulrik Frydkjaer-Olsen
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  2. Rasmus Soegaard Hansen
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  3. Tunde Peto
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  4. Jakob Grauslund
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Correspondence to Jakob Grauslund.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Frydkjaer-Olsen, U., Hansen, R.S., Peto, T. et al. Structural neurodegeneration correlates with early diabetic retinopathy. Int Ophthalmol 38, 1621–1626 (2018). https://doi.org/10.1007/s10792-017-0632-1

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  • DOI: https://doi.org/10.1007/s10792-017-0632-1

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