April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Exploring Retinal Markers of Diabetic Neuropathy
Author Affiliations & Notes
  • A. Moavenshahidi
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
  • G. P. Sampson
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
  • N. Pritchard
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
  • K. Edwards
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
  • D. Vagenas
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
  • A. Russell
    Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Woolloongabba, Australia
  • R. A. Malik
    Division of Cardiovascular Medicine, The University of Manchester, Manchester, United Kingdom
  • N. Efron
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia
  • Footnotes
    Commercial Relationships  A. Moavenshahidi, None; G.P. Sampson, None; N. Pritchard, None; K. Edwards, None; D. Vagenas, None; A. Russell, None; R.A. Malik, None; N. Efron, None.
  • Footnotes
    Support  National Health and Medical Research Council, George Weaber Foundation
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 2241. doi:
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      A. Moavenshahidi, G. P. Sampson, N. Pritchard, K. Edwards, D. Vagenas, A. Russell, R. A. Malik, N. Efron; Exploring Retinal Markers of Diabetic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2241.

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

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Abstract

Purpose: : To investigate the application of retinal nerve fibre layer (RNFL) thickness as a marker for severity of diabetic peripheral neuropathy (DPN) in people with Type 2 diabetes.

Methods: : This was a cross-sectional study whereby 61 participants (mean age 61 [41-75 years], mean duration of diabetes 14 [1-40 years], 70% male) with Type 2 diabetes and DPN underwent optical coherence tomography (OCT) scans. Global and 4 quadrant (TSNI) RNFL thicknesses were measured at 3.45mm around the optic nerve head of one eye. Neuropathy disability score (NDS) was used to assess the severity of DPN on a 0 to 10 scale. Participants were divided into three age-matched groups representing mild (NDS=3-5), moderate (NDS=6-8) and severe (NDS=9-10) neuropathy. Two regression models were fitted for statistical analysis: 1) NDS scores as co-variate for global and quadrant RNFL thicknesses, 2) NDS groups as a factor for global RNFL thickness only.

Results: : Mean (SD) RNFL thickness (µm) was 103(9) for mild neuropathy (n=34), 101(10) for moderate neuropathy (n=16) and 95(13) in the group with severe neuropathy (n=11). Global RNFL thickness and NDS scores were statistically significantly related (b=-1.20, p=0.048). When neuropathy was assessed across groups, a trend of thinner mean RNFL thickness was observed with increasing severity of neuropathy; however, this result was not statistically significant (F=2.86, p=0.065). TSNI quadrant analysis showed that mean RNFL thickness reduction in the inferior quadrant was 2.55 µm per 1 unit increase in NDS score (p=0.005). However, the regression coefficients were not statistically significant for RNFL thickness in the superior (b=-1.0, p=0.271), temporal (b=-0.90, p=0.238) and nasal (b=-0.99, p=0.205) quadrants.

Conclusions: : RNFL thickness was reduced with increasing severity of DPN and the effect was most evident in the inferior quadrant. Measuring RNFL thickness using OCT may prove to be a useful, non-invasive technique for identifying severity of DPN and may also provide additional insight into common mechanisms for peripheral neuropathy and RNFL damage.

Keywords: nerve fiber layer • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • diabetes 
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