Joana Tavares Ferreira1, Rita Proença2, Marta Alves3, Arnaldo Dias-Santos4, Bruno Oliveira Santos5, João Paulo Cunha4, Ana Luísa Papoila6, Luís Abegão Pinto7. 1. Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal; NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal. Electronic address: joanaptf@gmail.com. 2. Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal. 3. Epidemiology and Statistics Unit, Research Centre, Central Lisbon Hospital Center, Lisbon, Portugal. 4. Department of Ophthalmology, Central Lisbon Hospital Center, Lisbon, Portugal; NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal. 5. Department of Ophthalmology, Associação Médica Olhar bem, Lisbon, Portugal; CEris-ICIST, Instituto Superior Técnico, Lisbon University, Lisbon, Portugal. 6. Epidemiology and Statistics Unit, Research Centre, Central Lisbon Hospital Center, Lisbon, Portugal; NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal; CEAUL (Center of Statistics and Applications), Lisbon University, Lisbon, Portugal. 7. Visual Sciences Study Center, Faculty of Medicine, Lisbon University, Lisbon, Portugal; Department of Ophthalmology, Northern Lisbon Hospital Center, Lisbon, Portugal.
Abstract
PURPOSE: To identify changes in choroidal thickness (CT) and all retinal layers of diabetic patients without diabetic retinopathy (DR) after 1 year of follow-up. DESIGN: Prospective observational cohort study. METHODS: Overall, 125 diabetic patients without DR were included. Two visits were scheduled: the first visit (V1) and a second visit after 12 months (V2). At both visits, patients received a complete ophthalmologic evaluation that included OCT. Each retinal layer thickness was calculated for 9 ETDRS sectors, and CT was measured at 13 locations. Generalized linear mixed-effects models were used. RESULTS: Of the 125 patients, 103 completed the study, and 9 of the 103 developed DR (8.7%). CT was significantly higher at V2 than at V1, with an average value of 10-17 μm at almost half the locations (500, 1000, and 1500 μm temporal; 500 and 1000 μm nasal; and 1000 μm superior to the fovea) (P < .001-.003). The thicknesses of the ganglion cell layer (I3 and N6 sectors), inner plexiform layer (S6 and N6 sectors), inner nuclear layer (T6 and N6 sectors), and outer plexiform layer (S6 sector), as well as the overall retinal thickness (RT) (S3, N3, I3, S6, and T6 sectors), were decreased at V2 (P < .001). Visible retinopathy was negatively associated with overall RT (central, S3, T3, I3, and N3 sectors, P = .004-.024) and the thickness of the ONL (T6 and I6 sectors, P = .007 and P = .009) and photoreceptor layer (N6 sector, P = .038). The presence of DR decreased the overall RT by 13.04-16.63 μm. CONCLUSIONS: Diabetic patients without DR showed a thicker choroid and a thinner retina, particularly in inner layers, after 1 year of follow-up. These structural changes may correspond to the early neurodegenerative phase of DR.
PURPOSE: To identify changes in choroidal thickness (CT) and all retinal layers of diabeticpatients without diabetic retinopathy (DR) after 1 year of follow-up. DESIGN: Prospective observational cohort study. METHODS: Overall, 125 diabeticpatients without DR were included. Two visits were scheduled: the first visit (V1) and a second visit after 12 months (V2). At both visits, patients received a complete ophthalmologic evaluation that included OCT. Each retinal layer thickness was calculated for 9 ETDRS sectors, and CT was measured at 13 locations. Generalized linear mixed-effects models were used. RESULTS: Of the 125 patients, 103 completed the study, and 9 of the 103 developed DR (8.7%). CT was significantly higher at V2 than at V1, with an average value of 10-17 μm at almost half the locations (500, 1000, and 1500 μm temporal; 500 and 1000 μm nasal; and 1000 μm superior to the fovea) (P < .001-.003). The thicknesses of the ganglion cell layer (I3 and N6 sectors), inner plexiform layer (S6 and N6 sectors), inner nuclear layer (T6 and N6 sectors), and outer plexiform layer (S6 sector), as well as the overall retinal thickness (RT) (S3, N3, I3, S6, and T6 sectors), were decreased at V2 (P < .001). Visible retinopathy was negatively associated with overall RT (central, S3, T3, I3, and N3 sectors, P = .004-.024) and the thickness of the ONL (T6 and I6 sectors, P = .007 and P = .009) and photoreceptor layer (N6 sector, P = .038). The presence of DR decreased the overall RT by 13.04-16.63 μm. CONCLUSIONS:Diabeticpatients without DR showed a thicker choroid and a thinner retina, particularly in inner layers, after 1 year of follow-up. These structural changes may correspond to the early neurodegenerative phase of DR.
Authors: David Cordeiro Sousa; Inês Leal; Susana Moreira; Sónia do Vale; Ana S Silva-Herdade; Patrício Aguiar; Patrícia Dionísio; Luís Abegão Pinto; Miguel A R B Castanho; Carlos Marques-Neves Journal: Invest Ophthalmol Vis Sci Date: 2020-06-03 Impact factor: 4.799