Abstract
Purpose :
Diabetic retinopathy (DR) is one of the leading causes of preventable blindness and is associated with peripheral retinal vessel whitening (PRVW) which is related to lower vision compared to DR patients without PRVW. We investigate whether retinal structural differences may contribute to these changes.
Methods :
In this retrospective, observational clinical study, Optical Coherence Tomography (OCT) scans from retinal patients were collected from September 15, 2020 to December 29, 2021. Demographic data and DR severity were recorded. Patients were divided into three cohorts: patients with diabetes mellitus (DM) and PRVW, DM patients without PRVW, and control patients without DM.
A masked grader segmented the OCTs to determine the total retina, inner retinal, and outer retinal layer thicknesses. Average thicknesses were recorded by ETDRS sector. The severity of DR among DM patients was matched. Patients with DME were excluded to ensure that DME was not a confounder. Mean retinal sectoral thickness measurements were compared between groups with linear mixed-effects models. Statistics were analyzed using R software. P-values ≤ 0.05 were considered significant.
Results :
A total of 34 subjects were included (mean age 61.8±5.4years, 47.1% female). Of the 47 eyes, 15 (31.9%), 16 (34.0%), and 16 (34.0%) eyes were from patients with DM and PRVW, DM without PRVW and control patients respectively.
Overall, the retina of DM eyes with PRVW were significantly thinner than DM eyes without PRVW (P=0.026) and control eyes (P=0.049).
The inner retinal layer of DM eyes with PRVW was significantly thinner in the inner superior and temporal sectors compared to DM eyes without PRVW (P=0.009, P<0.001) and control eyes (P=0.034 P=0.002) respectively. The outer retinal layer of DM eyes with PRVW was also significantly thinner in the central, and inner superior and nasal sectors compared to DM eyes without PRVW (P=0.015, P=0.033 and P=0.030) and control eyes (P=0.007, P=0.005, P=0.013) respectively.
Conclusions :
Diabetic patients with PRVW had significantly decreased macular retinal thickness compared to the other cohorts, demonstrating a functional deficit in these patients. Although the central macula appears to be mainly involved, PRVW was associated with both inner and outer retinal thinning, suggesting an association with global thinning. This study supports identifying PRVW as a functional and prognostic marker in DM patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.