Abstract
Purpose :
To identify clinical characteristics and risk factors of retinal neurodegeneration represented with macular ganglion cell/inner plexiform layer (mGCIPL) thinning in patients with long-standing type 2 diabetes mellitus (T2DM)
Methods :
Patients who had T2DM for more than 15 years were prospectively recruited from September 2014 to July 2015. Clinical data and samples were collected according to the Common Data Element and Standards of Procedure developed by the Korean Diabetes Association research council. Baseline characteristics included age, gender, family history, medical record of comorbidity, and microvascular complication. All patients underwent optical coherence tomography with automatic segmentation of the mGCIPL in six parafoveal regions. Multivariable regression analysis identified factors associated with mGCIPL thinning
Results :
A total of 220 registered patients, 162 were included after ophthalmologic examination. The mean (SD) age was 65.0 (9.3) years, the mean duration of T2DM was 20.5 (4.0) years, and mGCIPL thickness was 76.2 (8.5) µm. Presence of hypertension, diabetic retinopathy, statin medication, estimated glomerular filtration rate , conduction velocity of posterior tibial, peroneal, and sural nerves, and cardiac autonomic neuropathy (CAN) score were significantly correlated with mGCIPL thickness. Multivariate regression analysis showed that the CAN score (coefficient = -1.78, p = .001) and sural nerve velocity (coefficient = 0.458, p = 0.035) yielded a significant, high regression coefficient with mGCIPL thickness (overall R2 = 0.46).
Conclusions :
This study demonstrated that various clinical features were associated with retinal neurodegeneration in T2DM. In particular, peripheral nerve conduction and autonomic nerve function were confirmed to be strong risk factors for mGCIPL thinning in patients with T2DM.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.