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Eline Elodie Barbara De Clerck, Jan Schouten, Tos TJM Berendschot, Fleur Goezinne, Miranda Schram, Coen Stehouwer, Caroll Webers; Glucose metabolism status is associated with changes in macular thickness: The Maastricht Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1601.
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© 2017 Association for Research in Vision and Ophthalmology.
Macular thinning may be an early sign of diabetic retinopathy and macular thickening may be an early sign of diabetic macular edema. We therefore evaluated to what extent macular thickness differed between individuals with prediabetes (preDM2) and individuals with type 2 diabetes (DM2) with or without cysts compared with individuals with a normal glucose metabolism (NGM).
This study was performed as part of The Maastricht Study, an ongoing population-based cohort study. Using SD-OCT we measured macular thickness in five ETDRS subfields in 2385 participants from The Maastricht Study (mean age 59±8 years, 50% men, 1397 NGM, 357 preDM2, 631 DM2). The cross-sections of the macular volume scans were reviewed individually and were scored for the presence of cysts.
After adjustment for age, sex, and spherical equivalent, individuals with preDM2 showed a significant decrease in pericentral superior macular thickness compared with individuals with NGM (-3.34±1.28 µm, P < 0.01). In individuals with DM2 without cystoid macular edema, the four pericentral quadrants were significantly thinner compared with individuals with NGM (range: -5.42±1.04 µm to -5.91±1.03 µm, P < 0.001). All pericentral macular thicknesses decreased with severity of glucose metabolism status. In individuals with DM2 with cystoid macular edema, the foveal thickness and center thickness were significantly increased (foveal thickness: +27.55±8.14 µm, P < 0.01; center thickness: +42.03±9.34 µm, P < 0.001).
This study demonstrates that the glucose metabolism status is associated with changes in macular thickness. The pericentral macular thickness decreases with worsening of glucose metabolism and may reflect early neurodegenerative changes. The foveal and center thicknesses significantly increase once cysts are present. Imaging and quantification of the macular thickness give the opportunity to study diabetic neuronal changes and to detect cystoid macular edema.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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