Abstract
Purpose :
To investigate the succession of the corresponding neurovascular and microstructure impairment in patients with full-course diabetic retinopathy.
Methods :
The electroretinography (ERG) was performed using a full-field flicker ERG recording device (RETeval). The vessel density (VD) and perfusion area (PA) of superficial capillary plexus (SCP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP) were quantified using optical coherence tomography angiography. The thickness of the retina, ganglion cell layer and Internal Plexiform layer (GCLIPL) and Ier core layer (INL) in the macular were also measured. The density, nearest neighbor distance (NND), dispersion and regularity of cones in the macular were measured with Adaptive optics scanning laser ophthalmoscopy (AOSLO).
Results :
Eighty-one patients were recruited, comprising 23 healthy controls, 23 in the DM without DR group (namely preclinical DR group), 13 in the NPDR group and 22 in the PDR group, covering the full-course DR. In the preclinical DR group, the decreased ERG amplitude was observed (P < 0.05), with no changes in retinal thickness, blood flow and microstructure. In NPDR, distinctive microstructural impairments were revealed by AOSLO, such as heightened NND, increased dispersion, reduced cone density, and diminished regularity (all P < 0.05). Delayed implicit time, decreased amplitude, increased retinal and INL thickness, decreased VD and PA of DCP were observed in NPDR (all P < 0.05). In PDR, continuous delayed implicit time and decreased amplitude dynamically indicated the functional impairment. More structural impairments were observed, including the increased thickness of GCLIP, and decreased VD and PA of DCP, ICP (all P < 0.05). Spearman correlation analysis demonstrated a significant correlation between functional parameters and various structural indicators, including VD, PA, thickness, and microstructural features such as cone regularity. (all P < 0.05).
Conclusions :
The cone pathway and bipolar cell layer function were reduced in preclinical DR. A distinct disorder in retinal microstructure was observed in NPDR. Notably, advanced devices will provide a more detailed exploration of the function and microstructure of the full-course DR, enhancing fresh insights of full-course DR.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.