Functional and structural findings of neurodegeneration in early stages of diabetic retinopathy: cross-sectional analyses of baseline data of the EUROCONDOR project

Ana Rita Santos, Luísa Ribeiro, Francesco Bandello, Rosangela Lattanzio, Catherine Egan, Ulrik Frydkjaer-Olsen, José García-Arumí, Jonathan Gibson, Jakob Grauslund, Simon P. Harding, Gabriele E. Lang, Pascale Massin, Edoardo Midena, Peter Scanlon, Stephen J. Aldington, Sílvia Simão, Christian Schwartz, Berta Ponsati, Massimo Porta, Miguel Ângelo CostaCristina Hernández, José Cunha-Vaz*, Rafael Simó,

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Cross-sectional study evaluating the relationship between: a) functional and structural measurements of neurodegeneration in initial stages of diabetic retinopathy (DR); and b) presence of neurodegeneration and early microvascular impairment. We analyzed baseline data of patients with type 2 diabetes (n=449) enrolled in the EUROCONDOR study (NCT01726075). Functional studies by multifocal ERG (mfERG) evaluated neurodysfunction and structural measurements using spectral domain optical-coherence tomography (SD-OCT) evaluated neurodegeneration. The mfERG P1 amplitude was more sensitive than the P1 implicit time (IT), and was lower in patients with ETDRS 20-35 than in patients with ETDRS <20 (p=0.005). In 58% of cases, mfERG abnormalities were present in the absence of visible retinopathy. Correspondence between SD-OCT thinning and mfERG abnormalities was shown in 67% of the eyes with ETDRS <20 and in 83% of the eyes with ETDRS 20-35. Notably, 32% of patients with ETDRS 20-35 presented no abnormalities in mfERG or SD-OCT. We conclude that there is a link between mfERG and SD-OCT measurements which increases with the presence of microvascular impairment. However, in our particular study population (ETDRS ≤ 35) a significant proportion of patients had normal GC-IPL thickness and normal mfERG findings. We raise the hypothesis that neurodegeneration may play a role in the pathogenesis of DR in many, but not in all type 2 diabetic patients.

Original languageEnglish
Pages (from-to)2503-2510
Number of pages8
JournalDiabetes
Volume66
Issue number9
Early online date29 Jun 2017
DOIs
Publication statusPublished - Sep 2017

Bibliographical note

© 2017 by the American Diabetes Association. http://www.diabetesjournals.org/content/license
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

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