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Kiyoung Kim, Jae Min Kim, Eung-Suk Kim, Seung-Young Yu; Retinal diabetic neurodegeneration as a predictive marker for progression of diabetic retinopathy in type 2 diabetes.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1919.
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To investigate baseline macular ganglion cell-inner plexiform (mGCIPL) thickness as a predictor of long-term progression of diabetic retinopathy (DR) in type 2 diabetes (T2DM).
This is retrospective longitudinal study. T2DM patients with no DR or mild NPDR were included and all patients were followed up more than 4 years. DR was graded in accordance to the ETDRS protocols and mean parafoveal mGCIPL thickness was measured using Cirrus HD-OCT (Carl Zeiss). Multivariable logistic regressions were performed to investigate mGCIPL thickness as a predictor of two-step progression, progression to proliferative DR (PDR), and incident diabetic macula edema (DME).
We included 91 patients (91 eyes). Of these, 38 had no retinopathy and 53 had mild NPDR. Baseline mGCIPL thickness, cardiac autonomic nerve score, peripheral nerve conduction velocity, and HbA1c were significantly associated with DR progression in univariate regression analysis. In multivariate regression models, baseline mGCIPL thickness was able to predict progression to two-step progression (OR 0.613, 95 % CI: [0.416–0.904), but not PDR (OR: 1.157, 95 % CI: [0.993–1.349]) and DME (OR: 1.093, 95 % CI: [0.908–1.316]).
We found that diabetic retinal neurodegeneration presented as mGCIPL thinning could predict long-term outcome of DR progression, notably before advanced retinopathy complications.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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