Thinning of the Retinal Nerve Fiber Layer, Ganglion Cell Layer and Macula of Patients with Diabetes Mellitus Type 2 Without or Minimal Retinal Findings on Fundoscopy Using Spectral Domain Optical Coherence Tomography


SCIENTIFIC POSTER


ABSTRACT

Objective:

This study aims to determine thinning of the retinal nerve fiber layer, ganglion cell layer and macula in relation to the risk of deterioration in vision in patients with Diabetes Mellitus Type 2 with no or minimal retinal findings. PARTICIPANTS: Thirty patients (sixty eyes) who consulted in the Ophthalmology Out Patient Department with Diabetes Mellitus Type 2 with no signs of DM Retinopathy (pre clinical diabetes) and with Mild DM Retinopathy or Moderate DM Retinopathy (clinical diabetes).

Method:

Participants were screened using a pre-determined inclusion and exclusion criteria. Best corrected visual acuity, slit lamp examination and indirect ophthalmoscopy were done before participants underwent Spectral Domain Optical Coherence Tomography of the Retinal Nerve Fiber Layer, Ganglion Cell Layer and Macula.

Results:

Patients included in the study were from 48 to 74 years old. A decrease in thickness of the Retinal Nerve Fiber Layer, Ganglion Cell Layer and Fovea were detected in eyes of patients with Diabetes Mellitus Type 2 with no, mild or moderate DM Retinopathy compared with the normative database using Spectral Domain Optical Coherence Tomography. Cirrus HD OCT showed significant retinal nerve fiber layer thinning in both pre clinical and clinical diabetes mellitus group (n= 60, Mean=94.9um, SD=12.85, p=0.05), pre clinical diabetes group (n= 52, Mean=93.69um, SD=13.19, p=0.05) and clinical diabetes group (n= 8,Mean=102.75um, SD=6.88, p=0.05). In both pre clinical and clinical diabetes group, there was significant thinning in the temporal (n=60, Mean= 71.05um, SD= 17.06, p= 0.05) and nasal (n=60, Mean= 69.45 um, SD= 9.36, p=0.05) quadrants of the retinal nerve fiber layer of the optic nerve head. In the pre clinical diabetes group, there was significant thinning in the temporal (n= 52, Mean= 70.39um, SD= 17.91, p= 0.05) and nasal (n=52, Mean= 68.83 um, SD= 9.31, p=0.05) quadrants of the retinal nerve fiber layer of the optic nerve head. In the clinical diabetes group, there was significant thinning in the temporal (n=8, Mean= 75.375um, SD= 9.59, p= 0.05), inferior (n=8, Mean= 128.125 um, SD=13.56, p=0.05) and nasal(n=8, Mean= 73.5 um, SD= 9.21, p=0.05) quadrants of the retinal nerve fiber layer of the optic nerve head. There was significant thinning of the macula in both pre clinical and clinical group (n=60, Mean= 270.77 um, SD= 16.08, p= 0.05) and pre clinical group (n=52, Mean= 269.60 um, SD= 16.09, p= 0.05) and clinical group. There was significant thinning of the fovea in both pre clinical and clinical group (n=60, Mean= 233.32 um, SD= 25.17, p= 0.05). There was significant thinning of the ganglion cell layer in both pre clinical and clinical group (n=60, Mean= 78.55 um, SD= 10.74, p= 0.05), pre clinical diabetes group (n=52, Mean= 77.40 um, SD= 10.83, p= 0.05) and clinical diabetes group (n=8, Mean= 86 um, SD= 6.65, p= 0.05).

Conclusion:

Thickness of the retinal nerve fiver layer of the optic nerve head, ganglion cell layer and macula were shown to be decreased in patients diagnosed with Diabetes Mellitus Type 2 even if they do not have ophthalmologic manifestations yet.


CONTACT DETAILS

Maria Clarissa Sobrio
Quezon City, Philippines
Email : clarissasobriomd@gmail.com
Cell Phone: +639218964501
Work Phone: +639218964501