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Eduardo B. Rodrigues, Muller Urias, Fernando Penha, Emmerson Badaró, Rodrigo Meirelles, Eduardo Novais, Michel Farah; Early neural retinal changes detected by spectral-domain optical coherence tomography in type 2 diabetes mellitus. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4427.
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To investigate the retinal changes prior to microangiopathy in type 2 diabetes mellitus (DM) patients with no diabetic retinopathy (DR) and in type 2 DM patients with mild DR only.
A cross-sectional study was performed in three groups: patients without DM, patients with type 2 DM without DR, and patients with type 2 DM with mild DR. Analysis of retinal layers was performed objectively with the Cirrus HD-OCT Review Software 6.0 (Carl Zeiss Meditec, Dublin, CA, USA). Macular cube and HD raster scans were analyzed with regard to: the ganglion cell layer + inner plexiform layer (GCL) analysis, retinal nerve fiber layer (RNFL) thickness, central subfoveal (CS) retinal thickness, average macular thickness and total retinal (RT) thickness.
In total, 102 patients were included in this study, of which 28 (27.4%) presented with mild DR and 46 (45.0%) were classified as DM patients with no DR. Quantitative analysis with the Cirrus software showed that the mean GCL and mean RNFL were thinner in the group with DM with no DR when compared to controls. ANOVA with Bonferroni correction indicated a statistically significant reduction in RT in mild RD (P = 0.032), in GCL in DM with no DR (P = 0.039) and mild DR (P = 0.003), and in RNFL in DM without DR or eyes with mild RD (P < 0.001), compared to controls.
Our study found reduction in thickness of GCL and RFNL in patients with DM without DR, which suggests neuroretinal changes before microangiopathy.
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