PMID- 31654034
OWN - NLM
STAT- MEDLINE
DCOM- 20210618
LR  - 20210618
IS  - 1476-5454 (Electronic)
IS  - 0950-222X (Print)
IS  - 0950-222X (Linking)
VI  - 34
IP  - 6
DP  - 2020 Jun
TI  - Early retinal neurodegeneration in preclinical diabetic retinopathy: a 
      multifactorial investigation.
PG  - 1100-1107
LID - 10.1038/s41433-019-0646-1 [doi]
AB  - BACKGROUND/OBJECTIVES: To investigate effects of microalbuminuria (MA), diabetes 
      duration, glycosylated haemoglobin (HbA1c) level, hypertension (HT) and/or 
      hyperlipidaemia (HL) coexistence on retinal layers in diabetic patients without 
      diabetic retinopathy (DR) using spectral-domain optical coherence tomography 
      (SD-OCT). SUBJECTS/METHODS: This cross-sectional study involved 95 (45 had MA and 
      50 had no MA) patients with type 2 diabetes mellitus (DM) without DR and 91 age- 
      and gender-matched non-diabetic controls. Macular and peripapillary SD-OCT 
      measurements (Heidelberg Engineering GmbH, Heidelberg, Germany), DM duration, 
      HbA1c levels and presence of HT and/or HL were used for statistical analyses. 
      RESULTS: The MA (+), MA (-) and control groups had similar age and gender 
      distribution (p > 0.05). The differences in SD-OCT measurements among the MA (+), 
      MA (-) and control groups were insignificant (p > 0.05). However, diabetic 
      patients (n = 95) had significantly thinner inferior-temporal peripapillary 
      retinal nerve fibre layer (RNFL) (p = 0.042) than in the controls (n = 91). 
      Superior peripapillary RNFL was significantly thinner in patients with an HbA1c 
      level > 7% (p = 0.049). However, 3 mm-nasal, temporal and superior perifoveal 
      thicknesses were significantly lower in patients with DM duration over 10 years 
      (p < 0.05). HT and/or HL coexistence did not lead a significant difference in 
      SD-OCT parameters among the groups. CONCLUSIONS: In diabetic patients without DR, 
      peripapillary inferior-temporal RNFL thinning might be an early sign of 
      neuroretinal degeneration and it seems to be independent from vascular 
      endothelial damage (MA). Poor metabolic control appears to lead superior 
      peripapillary RNFL thinning, while perifoveal thicknesses tend to decrease with 
      longer DM duration.
FAU - Toprak, Ibrahim
AU  - Toprak I
AUID- ORCID: 0000-0001-6325-7485
AD  - Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, 
      Turkey. ibrahimt@doctor.com.
FAU - Fenkci, Semin Melahat
AU  - Fenkci SM
AD  - Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale 
      University, Denizli, Turkey.
FAU - Fidan Yaylali, Guzin
AU  - Fidan Yaylali G
AD  - Department of Endocrinology and Metabolism, Faculty of Medicine, Pamukkale 
      University, Denizli, Turkey.
FAU - Martin, Cigdem
AU  - Martin C
AD  - Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, 
      Turkey.
FAU - Yaylali, Volkan
AU  - Yaylali V
AD  - Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Denizli, 
      Turkey.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20191025
PL  - England
TA  - Eye (Lond)
JT  - Eye (London, England)
JID - 8703986
SB  - IM
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2/complications
MH  - *Diabetic Retinopathy
MH  - Humans
MH  - Nerve Fibers
MH  - Retinal Ganglion Cells
MH  - Tomography, Optical Coherence
PMC - PMC7253424
COIS- The authors declare that they have no conflict of interest.
EDAT- 2019/10/28 06:00
MHDA- 2021/06/22 06:00
PMCR- 2021/06/01
CRDT- 2019/10/27 06:00
PHST- 2019/04/21 00:00 [received]
PHST- 2019/09/09 00:00 [accepted]
PHST- 2019/07/03 00:00 [revised]
PHST- 2019/10/28 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2019/10/27 06:00 [entrez]
PHST- 2021/06/01 00:00 [pmc-release]
AID - 10.1038/s41433-019-0646-1 [pii]
AID - 646 [pii]
AID - 10.1038/s41433-019-0646-1 [doi]
PST - ppublish
SO  - Eye (Lond). 2020 Jun;34(6):1100-1107. doi: 10.1038/s41433-019-0646-1. Epub 2019 
      Oct 25.