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M. Stehouwer, R. Bronsema, H. W. van Dijk, P. H. B. Kok, F. D. Verbraak; Structural and Functional Changes of the Fovea in Patients With Diabetes Mellitus Type 1 and No or Minimal Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1395.
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To evaluate if macular retinal thickness (RT) measured with spectral-domain optical coherence tomography (OCT) correlates with function of the fovea as measured with the Rarebit Fovea Test (RFT) of patients with type 1 diabetes and no or minimal diabetic retinopathy (DR).
Thirty-six patients, recruited from the outpatient clinic of the department of Internal Medicine at the Academic Medical Centre (University Hospital, Amsterdam, the Netherlands) underwent ophthalmic examination, stereoscopic fundus photographs, OCT and RFT. The patient group was divided in two subgroups; a patient group with minimal DR (n = 21) and a patient group without minimal DR (n = 15). Control subjects (n=44) were age and gender matched with patients.
In patients with diabetes type 1 and minimal DR the mean RT in the pericentral area of the macula was significantly thinner compared to healthy controls (p=0.038). The same patient group showed significantly decreased RFT results compared to age- and gender-matched controls (p=0.001). This thinner mean RT and decreased foveal function of the patients with diabetes type 1 and minimal DR showed a significant correlation (p = 0.029).
The thinning of the pericentral retina in patient with type 1 diabetes leads to functional loss of the fovea and supports the concept that early DR includes a neuro-degenerative component.
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