Retina and Choroid of Diabetic Patients Without Observed Retinal Vascular Changes

A Longitudinal Study

Joana Tavares-Ferreira, Rita Proença, Marta Alves, Arnaldo Dias-Santos, Bruno Oliveira Santos, João Paulo Cunha, Ana Luísa Papoila, Luís Abegão Pinto

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose To identify changes in choroidal thickness (CT) and all retinal layers of diabetic patients without diabetic retinopathy (DR) after 1 year of follow-up. Design Prospective observational cohort study. Methods Overall, 125 diabetic patients without DR were included. Two visits were scheduled: the first visit (V1) and a second visit after 12 months (V2). At both visits, patients received a complete ophthalmologic evaluation that included OCT. Each retinal layer thickness was calculated for 9 ETDRS sectors, and CT was measured at 13 locations. Generalized linear mixed-effects models were used. Results Of the 125 patients, 103 completed the study, and 9 of the 103 developed DR (8.7%). CT was significantly higher at V2 than at V1, with an average value of 10–17 μm at almost half the locations (500, 1000, and 1500 μm temporal; 500 and 1000 μm nasal; and 1000 μm superior to the fovea) (P <.001–.003). The thicknesses of the ganglion cell layer (I3 and N6 sectors), inner plexiform layer (S6 and N6 sectors), inner nuclear layer (T6 and N6 sectors), and outer plexiform layer (S6 sector), as well as the overall retinal thickness (RT) (S3, N3, I3, S6, and T6 sectors), were decreased at V2 (P <.001). Visible retinopathy was negatively associated with overall RT (central, S3, T3, I3, and N3 sectors, P =.004–.024) and the thickness of the ONL (T6 and I6 sectors, P =.007 and P =.009) and photoreceptor layer (N6 sector, P =.038). The presence of DR decreased the overall RT by 13.04–16.63 μm. Conclusions Diabetic patients without DR showed a thicker choroid and a thinner retina, particularly in inner layers, after 1 year of follow-up. These structural changes may correspond to the early neurodegenerative phase of DR.

Original languageEnglish
Pages (from-to)15-25
Number of pages11
JournalAmerican Journal of Ophthalmology
Volume176
DOIs
Publication statusPublished - Apr 2017

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Retinal Vessels
Choroid
Diabetic Retinopathy
Longitudinal Studies
Retina
S 6
Nijmegen Breakage Syndrome
Nose
Ganglia
Observational Studies
Cohort Studies

Cite this

@article{b9e1aee022e94473bd642d2d5d7faf23,
title = "Retina and Choroid of Diabetic Patients Without Observed Retinal Vascular Changes: A Longitudinal Study",
abstract = "Purpose To identify changes in choroidal thickness (CT) and all retinal layers of diabetic patients without diabetic retinopathy (DR) after 1 year of follow-up. Design Prospective observational cohort study. Methods Overall, 125 diabetic patients without DR were included. Two visits were scheduled: the first visit (V1) and a second visit after 12 months (V2). At both visits, patients received a complete ophthalmologic evaluation that included OCT. Each retinal layer thickness was calculated for 9 ETDRS sectors, and CT was measured at 13 locations. Generalized linear mixed-effects models were used. Results Of the 125 patients, 103 completed the study, and 9 of the 103 developed DR (8.7{\%}). CT was significantly higher at V2 than at V1, with an average value of 10–17 μm at almost half the locations (500, 1000, and 1500 μm temporal; 500 and 1000 μm nasal; and 1000 μm superior to the fovea) (P <.001–.003). The thicknesses of the ganglion cell layer (I3 and N6 sectors), inner plexiform layer (S6 and N6 sectors), inner nuclear layer (T6 and N6 sectors), and outer plexiform layer (S6 sector), as well as the overall retinal thickness (RT) (S3, N3, I3, S6, and T6 sectors), were decreased at V2 (P <.001). Visible retinopathy was negatively associated with overall RT (central, S3, T3, I3, and N3 sectors, P =.004–.024) and the thickness of the ONL (T6 and I6 sectors, P =.007 and P =.009) and photoreceptor layer (N6 sector, P =.038). The presence of DR decreased the overall RT by 13.04–16.63 μm. Conclusions Diabetic patients without DR showed a thicker choroid and a thinner retina, particularly in inner layers, after 1 year of follow-up. These structural changes may correspond to the early neurodegenerative phase of DR.",
author = "Joana Tavares-Ferreira and Rita Proen{\cc}a and Marta Alves and Arnaldo Dias-Santos and Santos, {Bruno Oliveira} and Cunha, {Jo{\~a}o Paulo} and Papoila, {Ana Lu{\'i}sa} and {Abeg{\~a}o Pinto}, Lu{\'i}s",
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Retina and Choroid of Diabetic Patients Without Observed Retinal Vascular Changes : A Longitudinal Study. / Tavares-Ferreira, Joana; Proença, Rita; Alves, Marta; Dias-Santos, Arnaldo; Santos, Bruno Oliveira; Cunha, João Paulo; Papoila, Ana Luísa; Abegão Pinto, Luís.

In: American Journal of Ophthalmology, Vol. 176, 04.2017, p. 15-25.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Retina and Choroid of Diabetic Patients Without Observed Retinal Vascular Changes

T2 - A Longitudinal Study

AU - Tavares-Ferreira, Joana

AU - Proença, Rita

AU - Alves, Marta

AU - Dias-Santos, Arnaldo

AU - Santos, Bruno Oliveira

AU - Cunha, João Paulo

AU - Papoila, Ana Luísa

AU - Abegão Pinto, Luís

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N2 - Purpose To identify changes in choroidal thickness (CT) and all retinal layers of diabetic patients without diabetic retinopathy (DR) after 1 year of follow-up. Design Prospective observational cohort study. Methods Overall, 125 diabetic patients without DR were included. Two visits were scheduled: the first visit (V1) and a second visit after 12 months (V2). At both visits, patients received a complete ophthalmologic evaluation that included OCT. Each retinal layer thickness was calculated for 9 ETDRS sectors, and CT was measured at 13 locations. Generalized linear mixed-effects models were used. Results Of the 125 patients, 103 completed the study, and 9 of the 103 developed DR (8.7%). CT was significantly higher at V2 than at V1, with an average value of 10–17 μm at almost half the locations (500, 1000, and 1500 μm temporal; 500 and 1000 μm nasal; and 1000 μm superior to the fovea) (P <.001–.003). The thicknesses of the ganglion cell layer (I3 and N6 sectors), inner plexiform layer (S6 and N6 sectors), inner nuclear layer (T6 and N6 sectors), and outer plexiform layer (S6 sector), as well as the overall retinal thickness (RT) (S3, N3, I3, S6, and T6 sectors), were decreased at V2 (P <.001). Visible retinopathy was negatively associated with overall RT (central, S3, T3, I3, and N3 sectors, P =.004–.024) and the thickness of the ONL (T6 and I6 sectors, P =.007 and P =.009) and photoreceptor layer (N6 sector, P =.038). The presence of DR decreased the overall RT by 13.04–16.63 μm. Conclusions Diabetic patients without DR showed a thicker choroid and a thinner retina, particularly in inner layers, after 1 year of follow-up. These structural changes may correspond to the early neurodegenerative phase of DR.

AB - Purpose To identify changes in choroidal thickness (CT) and all retinal layers of diabetic patients without diabetic retinopathy (DR) after 1 year of follow-up. Design Prospective observational cohort study. Methods Overall, 125 diabetic patients without DR were included. Two visits were scheduled: the first visit (V1) and a second visit after 12 months (V2). At both visits, patients received a complete ophthalmologic evaluation that included OCT. Each retinal layer thickness was calculated for 9 ETDRS sectors, and CT was measured at 13 locations. Generalized linear mixed-effects models were used. Results Of the 125 patients, 103 completed the study, and 9 of the 103 developed DR (8.7%). CT was significantly higher at V2 than at V1, with an average value of 10–17 μm at almost half the locations (500, 1000, and 1500 μm temporal; 500 and 1000 μm nasal; and 1000 μm superior to the fovea) (P <.001–.003). The thicknesses of the ganglion cell layer (I3 and N6 sectors), inner plexiform layer (S6 and N6 sectors), inner nuclear layer (T6 and N6 sectors), and outer plexiform layer (S6 sector), as well as the overall retinal thickness (RT) (S3, N3, I3, S6, and T6 sectors), were decreased at V2 (P <.001). Visible retinopathy was negatively associated with overall RT (central, S3, T3, I3, and N3 sectors, P =.004–.024) and the thickness of the ONL (T6 and I6 sectors, P =.007 and P =.009) and photoreceptor layer (N6 sector, P =.038). The presence of DR decreased the overall RT by 13.04–16.63 μm. Conclusions Diabetic patients without DR showed a thicker choroid and a thinner retina, particularly in inner layers, after 1 year of follow-up. These structural changes may correspond to the early neurodegenerative phase of DR.

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