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Li Yangjiani, Franziska G. Rauscher, Mengyu Wang, Raymond C S Wong, Dian Li, Jennifer K. Sun, Konstantinia Sampani, Kerstin Wirkner, Markus Loeffler, Joachim Thiery, Christoph Engel, Tobias Elze; Age-controlled correlation between blood HbA1c level and thicknesses of ten retinal layers on macular OCT volume scans. Invest. Ophthalmol. Vis. Sci. 2020;61(9):PP0010.
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The blood HbA1c level is a commonly used index to diagnose diabetes and to measure the long-term glycemic control for diabetic patients. Here, we study the age-controlled relationship between HbA1c and ten retinal layers segmented from spectral domain optical coherence tomography (OCT) macular volume scans in a large population-based study in Leipzig, Germany.
From the population-based, age and sex stratified LIFE-Adult study, all eyes of participants with reliable Spectralis SD-OCT (Heidelberg Engineering, Heidelberg, Germany) macular volume scans (97 horizontal B-scans with 512 A-scans each; reliability criterion: B-scan quality ≥ 20 dB) and available blood HbA1c level were included. Thicknesses of the following ten retinal layers were extracted from the OCT machine (Figure 1A): retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), inner segment (IS), inner-outer segment junction (IS-OS), outer segment (OS) and retinal pigmented epithelium layer (RPE). For each of the 49,664 A-scans of each layer, a partial Pearson correlation with HbA1c removing all variance explained by age was calculated. P-values were adjusted for multiple comparisons by the false-discovery method.
17,599 eyes of 8,893 participants were included (see Figure 1B and 1C for demographics). The age-controlled correlation of each A-scan is visualized in Figure 2. GCL and IPL showed a negative correlation (red) in parafoveal and perifoveal areas and a positive correlation (blue) in more peripheral areas, while RNFL exhibited an extensive negative correlation. The outer layers did not exhibit a fovea-featured pattern, but were negatively correlated in ONL, IS and IS-OS. Excluding all 1561 eyes of 787 participants treated with antidiabetic medication at the time of the study did not change the correlation patterns.
Retinal layers thicknesses and blood HbA1c level exhibited specific correlation patterns which differ between inner and outer layers. Generally, thinner RNFL, GCL, IPL, ONL, IS and IS-OS are associated with higher HbA1c. Blood HbA1c level can be reflected in the retina in pre-clinical or early stage diabetes patients, as indicated by our findings in our large sample of subjects without diabetic medication.
This is a 2020 Imaging in the Eye Conference abstract.
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