September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Impact of glycemic variability on neurosensory retina in patients with type 1 diabetes mellitus
Author Affiliations & Notes
  • Paola Giorno
    IRCCS-FONDAZIONE G.B.BIETTI, ROME, Italy
  • Fabiana Picconi
    Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy
  • Fabio Scarinci
    IRCCS-FONDAZIONE G.B.BIETTI, ROME, Italy
  • Simona Frontoni
    Endocrinology, Diabetes and Metabolism, S. Giovanni Calibita Fatebenefratelli Hospital, University of Rome Tor Vergata, Rome, Italy
  • Antonio Di Renzo
    IRCCS-FONDAZIONE G.B.BIETTI, ROME, Italy
  • Monica Varano
    IRCCS-FONDAZIONE G.B.BIETTI, ROME, Italy
  • Maria Cristina Parravano
    IRCCS-FONDAZIONE G.B.BIETTI, ROME, Italy
  • Footnotes
    Commercial Relationships   Paola Giorno, None; Fabiana Picconi, None; Fabio Scarinci, None; Simona Frontoni , None; Antonio Di Renzo, None; Monica Varano, None; Maria Cristina Parravano, None
  • Footnotes
    Support  NONE
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6318. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to Subscribers Only
      Sign In or Create an Account ×
    • Get Citation

      Paola Giorno, Fabiana Picconi, Fabio Scarinci, Simona Frontoni, Antonio Di Renzo, Monica Varano, Maria Cristina Parravano; Impact of glycemic variability on neurosensory retina in patients with type 1 diabetes mellitus. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6318.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Diabetic retinopathy (DR) is considered a retinal microvascular disorder. Recent studies demonstrated that retinal neurodegeneration might develop early in the course of DR, even before the onset of microvascular changes. The mechanisms by which hyperglycemia adversely affects the neurosensory retina are still not well understood. The aim of our study was to evaluate the impact of overall glycemic load and glycemic variability (GV) on the layers of retinal nerve tissue in patients with type 1 diabetes mellitus with no signs of DR or mild non proliferative DR .

Methods : 29 subjects with DM1 and 13 healthy subjects (C) were included. All subjects underwent a complete ophthalmological examination and Spectralis OCT evaluation. The thickness map of retinal layers, using the automatic segmentation, was performed and values were compared among groups. All DM1 patients underwent a Continuous Glucose Monitoring (CGM), from which indexes of GV were calculated. Overall glycemic load was evaluated by analyzing HbA1c values.

Results : Nasal retinal nerve fiber layer (RNFL) thickness was significantly different between DM1 patients and C (83.4±14.7 vs 90.8±13.8 μm, p=0.01). Inner nuclear layer (INL) thickness was significantly increased in nasal (97.38±12.53 vs 91.57±5.53μm, p<0.01), temporal (95±12.97vs 88.35±5.20μm, p<0.00), superior (98.65±13.42 vs 92.05±5.75μm, p<0.01) and inferior (95.61± 13.28 vs 90.33±5.50μm, p<0.02) quadrants in DM1 group vs controls. A significant relationship between RNFL thickness and Low blood glucose index (LBGi) (p=0.034) as well as between INL thickness and Continuous overall net glycemic activation-1 (CONGA-1, p=0.037), CONGA-2 (p=0.041), CONGA-4 (p=0.032) was found in DM1 patients. However, no significant relationship was found between OCT parameters and HbA1c values.

Conclusions : Retinal neurodegeneration is already present in DM1 patients with no or early signs of DR. VG, but not overall glycemic load, was found being the most detrimental for the development of structural changes of the neurosensory retina in DM1 patients, whereas the impact of overall glycemic load remains controversial.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×