https://doi.org/10.31288/oftalmolzh201835762

Clinical assessment of retinal ganglion cell complex changes in patient groups differing in severity of diabetic polyneuropathy

M.A. Karliychuk, Cand Sc (Med), Assoc. Prof.

Higher State Educational Establishment of Ukraine «Bukovinian State Medical University»; Chernivtsi (Ukraine)

E-mail: mari13karli@gmail.com                

TO CITE THIS ARTICLE: Karliychuk MA. Clinical assessment of retinal ganglion cell complex changes in patient groups differing in severity of diabetic polyneuropathy.  J.ophthalmol.(Ukraine).2018;3:57-62. https://doi.org/10.31288/oftalmolzh201835762

               

Background: To our knowledge, no clinical study has previously been performed to investigate changes in the retinal ganglion cell complex (GCC) in diabetes mellitus (DM) patients differing in severity of diabetic polyneuropathy (DPN).

Purpose: To identify changes in the GCC in patients with DPN differing in severity of the disease.

Materials and Methods: A total of 575 patients (1150 eyes) with type 2 diabetes mellitus were included in the prospective analysis. DPN was diagnosed in 210 (36.5%) patients with DM. In addition to routine eye examination, retinal OCT was performed, and the macular GCC was assessed.

Results: We found that the state of GCC in patients with DPN depends on the severity of the disease, and mean average GCC thicknesses in DM patients with N1A, N1B, and N3 stages DPN, were 8.4%, 8.6%, and 11.0% lower than in controls (95.8 ± 8.2 μm) (p < 0.001). In addition, in N1A, N1B, N2A, N2B and N3 stages DPN, mean focal loss volume (FLV) values were 8.4, 8.7, 14.1, 14.3, and 15.3 times, respectively, lower, whereas mean global loss volume (GLV) values were 119.1%, 124.8%, 231.3%, 239.6%, and 358.1%, respectively, higher, than in age-matched healthy controls.

Conclusion: Retinal ganglion cell complex changes depend on the severity of diabetic polyneuropathy.

Keywords: diabetic polyneuropathy, diabetes mellitus, ganglion cell complex

References

1.Belova AN, Kudykin MN, Sheiko GE. [Diabetic peripheral neuropathy: epidemiology, pathogenesis, clinic diagnostics, treatment]. I.P. Pavlov Russian Medical Biological Herald. 2016; 24 (4):139–44. Russian.

2.Levin OS. [Diabetic polyneuropathy: current approaches to diagnosis and pathogenetic therapy]. Klinitsist. 2013;7(2):54–62. Russian.

3.Shahidi AM, Sampson GP, Pritchard N. Exploring retinal and functional markers of diabetic neuropathy. Clin Exp Optom. 2010 Sep;93(5):309-23.
Crossref   Pubmed

4.Srinivasan S, Dehghani C, Pritchard N, Edwards K, Russell AW, et al. Optical coherence tomography predicts 4-year incident diabetic neuropathy. Ophthalmic Physiol Opt. 2017 Jul;37(4):451-9.
Crossref   Pubmed

5.Zhang L, Inoue M, Dong K, Yamamoto M. Retrograde axonal transport impairment of large- and medium-sized retinal ganglion cells in diabetic rat. Curr Eye Res. 2000 Feb;20(2):131-6.
Crossref   Pubmed

6.Barber AJ. Diabetic retinopathy: recent advances towards understanding neurodegeneration and vision loss. Sci China Life Sci. 2015 Jun;58(6):541-9
Crossref   Pubmed

7.van Dijk HW, Kok PH, Garvin M, Sonka M, Devries JH, Michels RP, et al. Selective loss of inner retinal layer thickness in type 1 diabetic patients with minimal diabetic retinopathy.  Invest Ophthalmol Vis Sci. 2009 Jul;50(7):3404-9.
Crossref   Pubmed

8.van Dijk HW, Verbraak FD, Kok PHB, Early neurodegeneration in the retina of type 2 diabetic patients.  Invest Ophthalmol Vis Sci. 2012 May 14;53(6):2715-9. 
Crossref   Pubmed

9.Carpineto P, Toto L, Aloia R, Ciciarelli V, Borrelli E, Vitacolonna E, et al. Neuroretinal alterations in the early stages of diabetic retinopathy in patients with type 2 diabetes mellitus. Eye (Lond). 2016 May;30(5):673-9.
Crossref   Pubmed

10.El-Fayoumi D, Badr Eldine NM, Esmael AF, Ghalwash D, Soliman HM. Retinal Nerve Fiber Layer and Ganglion Cell Complex Thicknesses Are Reduced in Children With Type 1 Diabetes With No Evidence of Vascular Retinopathy. Invest Ophthalmol Vis Sci. 2016 Oct 1;57(13):5355-5360.
Crossref   Pubmed

11.Kern TS, Barber AJ. Retinal ganglion cells in diabetes. J Physiol. 2008 Sep 15;586(18):4401-8.
Crossref   Pubmed

12.Ng DS,  Chiang PP, Tan G, Cheung CG, Cheng CY et al. Retinal ganglion cell neuronal damage in diabetes and diabetic retinopathy. Clin Exp Ophthalmol. 2016 May;44(4):243-50.
Crossref   Pubmed

13.Pekel E, Tufaner G, Kaya H, Kaşıkçı A, Deda G, Pekel G. Assessment of optic disc and ganglion cell layer in diabetes mellitus type 2. Medicine (Baltimore). 2017 Jul;96(29):e7556.
Crossref   Pubmed

14.Rodrigues E, Urias MG, Penha FM,  Badaró E, Meirelles R, et al. Diabetes induces changes in neuroretina before retinal vessels: a spectral-domain optical coherence tomography study. Int J Retina Vitreous. 2015 Apr 15;1:4.
Crossref   Pubmed

15.Simo R, Hernandez C; European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR). Neurodegeneration in the diabetic eye: new insights and therapeutic perspectives. Trends Endocrinol Metab. 2014 Jan;25(1):23-33.
Crossref   Pubmed

16.Kotov SV, Kalinin AP, Rudakova IG. Diabetic neuropathy. Moscow: Medical information agency; 2011. Russian.

17.Boulton AJ. Diabetic neuropathy: classification, measurement and treatment. Curr Opin Endocrinol Diabetes Obes. 2007 Apr;14(2):141-5.
Crossref   Pubmed