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Frank D. Verbraak, Hille Dijk v, Mona K. Garvin, Milan Sonka, Hans Vries de, Reinier Schlingemann, Michael D. Abramoff; Progressive Loss Of Innerr Retinal Layer Thickness In Type 1 Diabetic Patients With No Or Minimal Nonproliferative Diabetic Retinopahty Over 5 Years Of Follow-up. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2866.
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Previous studies demonstrated retinal neurodegeneration, selective loss of inner retinal layers in the pericentral area measured with OCT, in patients with type 1 diabetes mellitus and minimal diabetic retinopathy, compared to controls. The present study was conducted to detect possible progression of retinal neurodegeneration - progressive loss of thickness of inner retinal layers - in patients with type 1 diabetes mellitus, and no or minimal retinopathy at baseline.
Thirty-seven patients with type 1 diabetes mellitus and no or minimal (microaneurysms only) retinopathy at baseline, were examined every 6 months, during a follow-up period of 5 years with fundus photography and OCT (Stratus-OCT). Based on photography the retinopathy was scored as absent or present, and stable or progressive over the five year period. Following automated segmentation of intraretinal layers of the OCT images, mean thickness was calculated for 6 individual layers of the retina in the pericentral area (ETDRS region 2 to 5) of the macula. For each patient the change in thickness of this layers was calculated over the five year period.
Twenty two patients showed progressive retinopathy over a five year period, either from absent to present retinopathy or an increase in the number of microaneurysms / hemorhages.Over the five year follow-up period, the thickness of the retinal nerve fiber layer (RNFL) and the ganglion cell layer plus inner plexiform layer (GCL/IPL) in the pericentral area showed significant progressive loss (mean decrease RNFL: 1.0 micron ± 3.3 micron, p = 0.07; mean decrease GCL/IPL: 1.6 micron ± 5.1 micron, p = 0.06).
This study demonstrated progression of neurodegeneration, progressive loss of inner retinal layers measured with OCT over a 5 year period, in patients with type 1 diabetes mellitus and no or minimal diabetic retinopathy .
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