TY - JOUR
T1 - Re-evaluating diabetic papillopathy using optical coherence tomography and inner retinal sublayer analysis
AU - Huemer, Josef
AU - Khalid, Hagar
AU - Ferraz, Daniel
AU - Faes, Livia
AU - Korot, Edward
AU - Jurkute, Neringa
AU - Balaskas, Konstantinos
AU - Egan, Catherine A.
AU - Petzold, Axel
AU - Keane, Pearse A.
N1 - Funding Information: JH has received speaker fees from Zeiss and Bayer and travel grants from Bayer. He has served on advisory boards for Roche. HK has received speaker fees from Zeiss. PAK has received speaker fees from Heidelberg Engineering, Topcon, Carl Zeiss Meditec AG, Haag-Streit, Allergan, Novartis, and Bayer. He has served on advisory boards for Novartis and Bayer and has been an external consultant for DeepMind and Optos. AP has received consultation fees from Novartis and Heidelberg Engineering, grants from Novartis, Stichting MS Research and ECTRIMS, outside the submitted work; and is part of the steering committee of the OCTiMS (Novartis) and the Zeiss Angio Network. LF is a panelist of the International Retinal Panel 2019-21 (Allergan) and has received the Swiss RetinAward 2019 (Bayer). Other authors have no financial disclosures. The sponsors had no rule in the design or conduct of this research. Funding Information: HK is supported by a scholarship from Egyptian mission sector, Ministry of Higher Education, Egypt. The funding organisation has no role in the design or conduct of this study. DF is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) Foundation, Ministry of Education of Brazil, Brasilia,́ DF, Brazil. PAK is supported by a Career Development (190028A) Awards from Moorfields Eye Charity, a UK Research & Innovation (UKRI) Future Leaders Fellowship (MR/ T019050/1), and a UK National Institute for Health Research (NIHR) Clinician Scientist Award (NIHR-CS–2014-12-023). Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Background/Objectives: To re-evaluate diabetic papillopathy using optical coherence tomography (OCT) for quantitative analysis of the peripapillary retinal nerve fibre layer (pRNFL), macular ganglion cell layer (mGCL) and inner nuclear layer (mINL) thickness. Subjects/Methods: In this retrospective observational case series between June 2008 and July 2019 at Moorfields Eye hospital, 24 eyes of 22 patients with diabetes and optic disc swelling with confirmed diagnosis of NAION or diabetic papillopathy by neuro-ophthalmological assessment were included for evaluation of the pRNFL, mGCL and mINL thicknesses after resolution of optic disc swelling. Results: The mean age of included patients was 56.5 (standard deviation (SD) ± 14.85) years with a mean follow-up duration of 216 days. Thinning of pRNFL (mean: 66.26, SD ± 31.80 µm) and mGCL (mean volume: 0.27 mm 3, SD ± 0.09) were observed in either group during follow-up, the mINL volume showed no thinning with 0.39 ± 0.05 mm 3. The mean decrease in visual acuity was 4.13 (SD ± 14.27) ETDRS letters with a strong correlation between mGCL thickness and visual acuity (rho 0.74, p < 0.001). Conclusion: After resolution of acute optic disc swelling, atrophy of pRNFL and mGCL became apparent in all cases of diabetic papillopathy and diabetic NAION, with preservation of mINL volumes. Analysis of OCT did not provide a clear diagnostic distinction between both entities. We suggest a diagnostic overlay with the degree of pRNFL and mGCL atrophy of prognostic relevance for poor visual acuity independent of the semantics of terminology.
AB - Background/Objectives: To re-evaluate diabetic papillopathy using optical coherence tomography (OCT) for quantitative analysis of the peripapillary retinal nerve fibre layer (pRNFL), macular ganglion cell layer (mGCL) and inner nuclear layer (mINL) thickness. Subjects/Methods: In this retrospective observational case series between June 2008 and July 2019 at Moorfields Eye hospital, 24 eyes of 22 patients with diabetes and optic disc swelling with confirmed diagnosis of NAION or diabetic papillopathy by neuro-ophthalmological assessment were included for evaluation of the pRNFL, mGCL and mINL thicknesses after resolution of optic disc swelling. Results: The mean age of included patients was 56.5 (standard deviation (SD) ± 14.85) years with a mean follow-up duration of 216 days. Thinning of pRNFL (mean: 66.26, SD ± 31.80 µm) and mGCL (mean volume: 0.27 mm 3, SD ± 0.09) were observed in either group during follow-up, the mINL volume showed no thinning with 0.39 ± 0.05 mm 3. The mean decrease in visual acuity was 4.13 (SD ± 14.27) ETDRS letters with a strong correlation between mGCL thickness and visual acuity (rho 0.74, p < 0.001). Conclusion: After resolution of acute optic disc swelling, atrophy of pRNFL and mGCL became apparent in all cases of diabetic papillopathy and diabetic NAION, with preservation of mINL volumes. Analysis of OCT did not provide a clear diagnostic distinction between both entities. We suggest a diagnostic overlay with the degree of pRNFL and mGCL atrophy of prognostic relevance for poor visual acuity independent of the semantics of terminology.
UR - http://www.scopus.com/inward/record.url?scp=85109811729&partnerID=8YFLogxK
U2 - https://doi.org/10.1038/s41433-021-01664-1
DO - https://doi.org/10.1038/s41433-021-01664-1
M3 - Article
C2 - 34244671
SN - 0950-222X
JO - Eye (Basingstoke)
JF - Eye (Basingstoke)
ER -