Comparison of Retinal Nerve Fiber Layer Thickness in Diabetic Patients with and without Diabetic Retinopathy and Healthy Individuals using Ocular Coherence Tomography
DOI:
https://doi.org/10.31674/mjmr.2023.v07i03.002Abstract
Objectives: Using Ocular Coherence Tomography, the study aimed to examine the RNFL thickness of type diabetics, patients with Diabetic Retinopathy, and healthy persons. Methods: 101 patients from the outside patient department and the Retina department of Tertiary Eye Care Hospital participated in this research. The cross-sectional study design was used. Non-probability consecutive sampling was utilized as the sampling technique. Patients were selected according to inclusion criteria. Visual Acuity was assessed using an (ETDRS) Early Treatment Diabetic Retinopathy Study Visual acuity chart at a distance of 6m. After the Ophthalmological Examination was done by a doctor, Ocular Coherence Tomography (Heidelberg Spectralis) was performed to assess RNFL thickness. The association between different types of diabetic retinopathy, Type-2 Diabetes, Normal Healthy, and retinal RNFL thickness was determined using a one-way ANOVA test. Results: The age range of the participants was between 40 and 69 years, with a mean of 55.68 ±10.437 years. 15.3% had diabetes for 1 to 5 years. 24% had Diabetes for 6 to 10 yea 19.9% had a Diabetes duration of 19.9%. The RNFL thickness was significantly decreased in type 2 diabetics, NPDR, and PDR as compared to normal Healthy individuals (p<.001). Age and duration of diabetes were closely correlated with the retinal nerve fiber layer (p<0.001). Conclusion: This study indicated that the (retinal nerve fiber layer) RNFL was considerably thinner in all quadrants of diabetic retinopathy (NPDR, PDR), type 2 diabetics, and healthy persons. Age and duration of diabetes were significantly correlated with average RNFL thickness.
Keywords:
Non-Proliferative, Diabetes Mellitus, Ocular Coherence Tomography, Proliferative Diabetic Retinopathy, Retinal Nerve Fiber LayerDownloads
References
Afef, M., Asma, K., Chaker, B., Faida, A., & Riadh, R. (2019). Retinal fiber layer and macular ganglion cell layer thickness in diabetic patients. Journal of Clinical and Experimental Ophthalmology, 10(785), 2.
Araszkiewicz, A., Zozulinska-Ziolkiewicz, D., Meller, M., Bernardczyk-Meller, J., Pilacinski, S., Rogowicz-Frontczak, A., ... & Wierusz-Wysocka, B. (2012). Neurodegeneration of the retina in type 1 diabetic patients. Polskie Archiwum Medycyny Wewnetrznej, 122(10), 464-470.
Barber, A. J., Lieth, E., Khin, S. A., Antonetti, D. A., Buchanan, A. G., & Gardner, T. W. (1998). Neural apoptosis in the retina during experimental and human diabetes. Early onset and effect of insulin. The Journal of Clinical Investigation, 102(4), 783-791.
Chen, X., Nie, C., Gong, Y., Zhang, Y., Jin, X., Wei, S., & Zhang, M. (2015). Peripapillary retinal nerve fiber layer changes in preclinical diabetic retinopathy: a meta-analysis. PloS One, 10(5), e0125919. https://doi.org/10.1371/journal.pone.0125919
De Faria, J. L., Russ, H., & Costa, V. P. (2002). Retinal nerve fibre layer loss in patients with type 1 diabetes mellitus without retinopathy. British Journal of Ophthalmology, 86(7), 725-728. http://dx.doi.org/10.1136/bjo.86.7.725
Dhasmana, R., Sah, S., & Gupta, N. (2016). Study of retinal nerve fibre layer thickness in patients with diabetes mellitus using fourier domain optical coherence tomography. Journal of Clinical and Diagnostic Research: JCDR, 10(7), NC05. https://doi/10.7860/JCDR/2016/19097.8107
Ezhilvendhan, K., Shenoy, A., Rajeshkannan, R., Balachandrachari, S., & Sathiyamoorthy, A. (2021). Evaluation of macular thickness, retinal nerve fiber layer and ganglion cell layer thickness in patients among type 2 diabetes mellitus using optical coherence tomography. Journal of Pharmacy & Bioallied Sciences, 13(Suppl 2), S1055. https://doi/10.4103/jpbs.jpbs_165_21
Gardner, T. W., Antonetti, D. A., Barber, A. J., LaNoue, K. F., Levison, S. W., & Penn State Retina Research Group. (2002). Diabetic retinopathy: more than meets the eye. Survey of Ophthalmology, 47, S253-S262. https://doi.org/10.1016/S0039-6257(02)00387-9
Goebel, W., & Kretzchmar-Gross, T. (2002). Retinal thickness in diabetic retinopathy: a study using optical coherence tomography (OCT). Retina, 22(6), 759-767.
Jia X., Zhong, Z., Bao, T., Wang, S., Jiang, T., Zhang, Y., ... & Zhu, X. (2020). Evaluation of early retinal nerve injury in type 2 diabetes patients without diabetic retinopathy. Frontiers in Endocrinology, 11, 475672. https://doi.org/10.3389/fendo.2020.475672
Karti, O., Nalbantoglu, O., Abali, S., Ayhan, Z., Tunc, S., Kusbeci, T., & Ozkan, B. (2017). Retinal ganglion cell loss in children with type 1 diabetes mellitus without diabetic retinopathy. Ophthalmic Surgery, Lasers and Imaging Retina, 48(6), 473-477. https://doi.org/10.3928/23258160-20170601-05
Lee, M. W., Lee, W. H., Ryu, C. K., Lee, Y. M., Lee, Y. H., & Kim, J. Y. (2021). Peripapillary retinal nerve fiber layer and microvasculature in prolonged type 2 diabetes patients without clinical diabetic retinopathy. Investigative Ophthalmology & Visual Science, 62(2), 9-9. https://doi.org/10.1167/iovs.62.2.9
Lim, H. B., Shin, Y. I., Lee, M. W., Park, G. S., & Kim, J. Y. (2019). Longitudinal changes in the peripapillary retinal nerve fiber layer thickness of patients with type 2 diabetes. JAMA Ophthalmology, 137(10), 1125-1132.
Marques, I. P., Alves, D., Santos, T., Mendes, L., Santos, A. R., Lobo, C., ... & Cunha-Vaz, J. (2019). Multimodal imaging of the initial stages of diabetic retinopathy: different disease pathways in different patients. Diabetes, 68(3), 648-653. https://doi.org/10.2337/db18-1077
Mehboob, M. A., Amin, Z. A., & Islam, Q. U. (2019). Comparison of retinal nerve fiber layer thickness between normal population and patients with diabetes mellitus using optical coherence tomography. Pakistan Journal of Medical Sciences, 35(1), 29. https://doi/10.12669/pjms.35.1.65
Meo, S. A., Zia, I., Bukhari, I. A., & Arain, S. A. (2016). Type 2 diabetes mellitus in Pakistan: Current prevalence and future forecast. The Journal of the Pakistan Medical Association, 66(12), 1637-1642.
Mumtaz, S. N., Fahim, M. F., Arslan, M., Shaikh, S. A., Kazi, U., & Memon, M. S. (2018). Prevalence of diabetic retinopathy in Pakistan; A systematic review. Pakistan Journal of Medical Sciences, 34(2), 493. https://doi/10.12669/pjms.342.13819
Ng, D. S., Chiang, P. P., Tan, G., Cheung, C. G., Cheng, C. Y., Ngung, C. Y., ... & Ikram, M. K. (2016). Retinal ganglion cell neuronal damage in diabetes and diabetic retinopathy. Clinical & Experimental Ophthalmology, 44(4), 243-250. https://doi.org/10.1111/ceo.12724
Oshitari, T. (2006). Non‐viral gene therapy for diabetic retinopathy. Drug development research, 67(11), 835-841. https://doi.org/10.1002/ddr.20157
Oshitari, T., Hata, N., & Yamamoto, S. (2008). Endoplasmic reticulum stress and diabetic retinopathy. Vascular Health and Risk Management, 4(1), 115-122.
Pekel, E., Tufaner, G., Kaya, H., Kaşıkçı, A., Deda, G., & Pekel, G. (2017). Assessment of optic disc and ganglion cell layer in diabetes mellitus type 2. Medicine, 96(29). https://doi/10.1097/MD.0000000000007556
Ramappa, R., & Thomas, R. K. (2016). Changes of Macular and Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography in Diabetic Patients with and without Diabetic Retinopathy. International Journal of Scientific Study, 3(12), 27-33.
Sohail, M. (2014). Prevalence of Diabetic Retinopathy among Type? 2 Diabetes Patients in Pakistan? Vision Registry. Pakistan Journal of Ophthalmology, 30(4).
Sohn, E. H., van Dijk, H. W., Jiao, C., Kok, P. H., Jeong, W., Demirkaya, N., ... & Abràmoff, M. D. (2016). Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus. Proceedings of the National Academy of Sciences, 113(19), E2655-E2664. https://doi.org/10.1073/pnas.1522014113
Srinivasan, S., Dehghani, C., Pritchard, N., Edwards, K., Russell, A. W., Malik, R. A., & Efron, N. (2017). Corneal and retinal neuronal degeneration in early stages of diabetic retinopathy. Investigative Ophthalmology & Visual Science, 58(14), 6365-6373. https://doi.org/10.1167/iovs.17-22736
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Malaysian Journal of Medical Research (MJMR)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
