TY - JOUR
T1 - The spatial relation of diabetic retinal neurodegeneration with diabetic retinopathy
AU - Van De Kreekeid, Jacoba A.
AU - Darma, Stanley
AU - Yinid, Jill M.P.L.Chan Pin
AU - Tan, H. Stevie
AU - Abramoff, Michael D.
AU - Twisk, Jos W.R.
AU - Verbraak, Frank D.
PY - 2020/4
Y1 - 2020/4
N2 - Purpose Diabetic retinal neurodegeneration (DRN) has been demonstrated in eyes of patients with diabetes mellitus (DM), even in the absence of diabetic retinopathy (DR). However, no studies have looked at the rate of change in retinal layers and presence/development of DR over time per quadrant of the macula. In this longitudinal study, we aimed to clarify whether the rate of DRN is associated with the development/presence of DR within 4 different quadrants of the retina. Methods 80 eyes of 40 patients with type 1 DM and no/minimal DR were included. At 4 visits over 6 years, SD-OCT and fundus images were acquired. Thickness of the Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Layer (GCL) and Inner Plexiform Layer (IPL) was measured in a 1-6mm circle around the fovea overall and for each quadrant (superior, nasal, inferior, temporal). Fundus images were scored for the presence/absence of DR in these areas. Multilevel analyses were performed to determine the rate of change for each layer overall and per quadrant for eyes/quadrants without and with DR during the follow-up period. Results RNFL and GCL showed significant thinning over time, IPL significant thickening. These changes were more pronounced for GCL and IPL in eyes/quadrants with DR during the follow-up period. Conclusions RNFL and GCL both showed thinning over time, which was more pronounced in eyes with DR for GCL. This holds true even in regional parts of the retina, as quadrant analyses showed similar results, showing that structural DRN is associated with DR per quadrant independently.
AB - Purpose Diabetic retinal neurodegeneration (DRN) has been demonstrated in eyes of patients with diabetes mellitus (DM), even in the absence of diabetic retinopathy (DR). However, no studies have looked at the rate of change in retinal layers and presence/development of DR over time per quadrant of the macula. In this longitudinal study, we aimed to clarify whether the rate of DRN is associated with the development/presence of DR within 4 different quadrants of the retina. Methods 80 eyes of 40 patients with type 1 DM and no/minimal DR were included. At 4 visits over 6 years, SD-OCT and fundus images were acquired. Thickness of the Retinal Nerve Fiber Layer (RNFL), Ganglion Cell Layer (GCL) and Inner Plexiform Layer (IPL) was measured in a 1-6mm circle around the fovea overall and for each quadrant (superior, nasal, inferior, temporal). Fundus images were scored for the presence/absence of DR in these areas. Multilevel analyses were performed to determine the rate of change for each layer overall and per quadrant for eyes/quadrants without and with DR during the follow-up period. Results RNFL and GCL showed significant thinning over time, IPL significant thickening. These changes were more pronounced for GCL and IPL in eyes/quadrants with DR during the follow-up period. Conclusions RNFL and GCL both showed thinning over time, which was more pronounced in eyes with DR for GCL. This holds true even in regional parts of the retina, as quadrant analyses showed similar results, showing that structural DRN is associated with DR per quadrant independently.
KW - Adult
KW - Diabetes Mellitus, Type 1/complications
KW - Diabetic Retinopathy/etiology
KW - Female
KW - Fundus Oculi
KW - Humans
KW - Longitudinal Studies
KW - Macula Lutea/pathology
KW - Male
KW - Retina/pathology
KW - Retinal Degeneration/etiology
KW - Retinal Neurons/pathology
KW - Tomography, Optical Coherence
UR - http://www.scopus.com/inward/record.url?scp=85083380692&partnerID=8YFLogxK
U2 - https://doi.org/10.1371/journal.pone.0231552
DO - https://doi.org/10.1371/journal.pone.0231552
M3 - Article
C2 - 32298369
SN - 1932-6203
VL - 15
JO - PLOS ONE
JF - PLOS ONE
IS - 4
M1 - e0231552
ER -