PURPOSE: To detect and localise subtle changes in retinas of diabetic patients who clinically have no diabetic retinopathy (DR) or non-proliferative DR (NPDR) as compared to age- and sex- matched controls. Spectral Domain Optical Coherence Tomography (SD-OCT) and software to examine all retinal layers, including deeper layers, were used to quantify foveal avascular zone size and inner and outer retinal layer thicknesses, as well as to detect axial location of prominent lesions. METHODS: Diabetic subjects, 19 total with 16 having no DR and three having non-proliferative retinopathy, were matched with 19 controls with respect to age and sex. Macular-centred SD-OCT grids of 20 × 15° were taken with the Spectralis. En face or transverse images were generated from the SD-OCT data by automatically segmenting all retinal layers. The transverse images were investigated for foveal avascular zone (FAZ) size, retinal vessel calibre, and structural changes. The size of the FAZ was compared for diabetics vs controls using vendor software and manual marking in Photoshop. Inner retinal layer (IRLFAZ ) and outer nuclear layer (ONLFAZ ) thicknesses at the margins of the FAZ were measured using vendor software. RESULTS: The FAZ area was larger for diabetics (mean ± S.D. = 0.388 ± 0.074 mm2 ) than controls (0.243 ± 0.113 mm2 ), t18 = 5.27, p < 0.0001, using vendor software. The mean IRLFAZ was thicker for the diabetics (86.8 ± 14.5 μm) than controls (65.2 ± 16.3 μm), t18 = 4.59, p = 0.00023, despite lack of exudation by clinical exam. There was no significant association between FAZ area and mean IRLFAZ for the diabetics, r = 0.099, p = 0.69. Vessels not clinically detected were visible in the NFL transverse image of most diabetics, especially for a mild NPDR patient. A prominent lesion found in the en face infra-red image of a mild NPDR subject was localised in the photoreceptor layer by SD-OCT, as well as additional outer retinal changes in other subjects. CONCLUSIONS: Our results demonstrate changes in inner and outer diabetic retinas not readily detectable by clinical exam. IRLFAZ had not thinned at the margins of the large FAZs, indicating neural mass did not yet decrease despite potential ischemia.
PURPOSE: To detect and localise subtle changes in retinas of diabeticpatients who clinically have no diabetic retinopathy (DR) or non-proliferative DR (NPDR) as compared to age- and sex- matched controls. Spectral Domain Optical Coherence Tomography (SD-OCT) and software to examine all retinal layers, including deeper layers, were used to quantify foveal avascular zone size and inner and outer retinal layer thicknesses, as well as to detect axial location of prominent lesions. METHODS:Diabetic subjects, 19 total with 16 having no DR and three having non-proliferative retinopathy, were matched with 19 controls with respect to age and sex. Macular-centred SD-OCT grids of 20 × 15° were taken with the Spectralis. En face or transverse images were generated from the SD-OCT data by automatically segmenting all retinal layers. The transverse images were investigated for foveal avascular zone (FAZ) size, retinal vessel calibre, and structural changes. The size of the FAZ was compared for diabetics vs controls using vendor software and manual marking in Photoshop. Inner retinal layer (IRLFAZ ) and outer nuclear layer (ONLFAZ ) thicknesses at the margins of the FAZ were measured using vendor software. RESULTS: The FAZ area was larger for diabetics (mean ± S.D. = 0.388 ± 0.074 mm2 ) than controls (0.243 ± 0.113 mm2 ), t18 = 5.27, p < 0.0001, using vendor software. The mean IRLFAZ was thicker for the diabetics (86.8 ± 14.5 μm) than controls (65.2 ± 16.3 μm), t18 = 4.59, p = 0.00023, despite lack of exudation by clinical exam. There was no significant association between FAZ area and mean IRLFAZ for the diabetics, r = 0.099, p = 0.69. Vessels not clinically detected were visible in the NFL transverse image of most diabetics, especially for a mild NPDR patient. A prominent lesion found in the en face infra-red image of a mild NPDR subject was localised in the photoreceptor layer by SD-OCT, as well as additional outer retinal changes in other subjects. CONCLUSIONS: Our results demonstrate changes in inner and outer diabetic retinas not readily detectable by clinical exam. IRLFAZ had not thinned at the margins of the large FAZs, indicating neural mass did not yet decrease despite potential ischemia.
Authors: Stephen A Burns; Ann E Elsner; Toco Y Chui; Dean A Vannasdale; Christopher A Clark; Thomas J Gast; Victor E Malinovsky; Anh-Danh T Phan Journal: Biomed Opt Express Date: 2014-02-27 Impact factor: 3.732
Authors: O Arend; S Wolf; A Remky; W E Sponsel; A Harris; B Bertram; M Reim Journal: Graefes Arch Clin Exp Ophthalmol Date: 1994-04 Impact factor: 3.117
Authors: Goodarz Danaei; Mariel M Finucane; John K Lin; Gitanjali M Singh; Christopher J Paciorek; Melanie J Cowan; Farshad Farzadfar; Gretchen A Stevens; Stephen S Lim; Leanne M Riley; Majid Ezzati Journal: Lancet Date: 2011-02-03 Impact factor: 79.321
Authors: Lucie Sawides; Kaitlyn A Sapoznik; Alberto de Castro; Brittany R Walker; Thomas J Gast; Ann E Elsner; Stephen A Burns Journal: Invest Ophthalmol Vis Sci Date: 2017-07-01 Impact factor: 4.799
Authors: Edmund Arthur; Ann E Elsner; Kaitlyn A Sapoznik; Joel A Papay; Matthew S Muller; Stephen A Burns Journal: Invest Ophthalmol Vis Sci Date: 2019-05-01 Impact factor: 4.799
Authors: Ann E Elsner; Joel A Papay; Kirby D Johnston; Lucie Sawides; Alberto de Castro; Brett J King; Durand W Jones; Christopher A Clark; Thomas J Gast; Stephen A Burns Journal: Ophthalmic Physiol Opt Date: 2020-02-04 Impact factor: 3.117
Authors: Jessica Alber; Edmund Arthur; Stuart Sinoff; Delia Cabrera DeBuc; Emily Y Chew; Lori Douquette; Wendy V Hatch; Chris Hudson; Amir Kashani; Cecelia S Lee; Stephen Montaquila; Sima Mozdbar; Leonardo Provetti Cunha; Faryan Tayyari; Gregory Van Stavern; Peter J Snyder Journal: Alzheimers Dement (Amst) Date: 2020-11-01
Authors: Ann E Elsner; Brittany R Walker; Robert N Gilbert; Vamsi Parimi; Joel A Papay; Thomas J Gast; Stephen A Burns Journal: Front Med (Lausanne) Date: 2022-03-17