TY - JOUR
T1 - Functional and structural findings of neurodegeneration in early stages of diabetic retinopathy
T2 - cross-sectional analyses of baseline data of the EUROCONDOR project
AU - Santos, Ana Rita
AU - Ribeiro, Luísa
AU - Bandello, Francesco
AU - Lattanzio, Rosangela
AU - Egan, Catherine
AU - Frydkjaer-Olsen, Ulrik
AU - García-Arumí, José
AU - Gibson, Jonathan
AU - Grauslund, Jakob
AU - Harding, Simon P.
AU - Lang, Gabriele E.
AU - Massin, Pascale
AU - Midena, Edoardo
AU - Scanlon, Peter
AU - Aldington, Stephen J.
AU - Simão, Sílvia
AU - Schwartz, Christian
AU - Ponsati, Berta
AU - Porta, Massimo
AU - Costa, Miguel Ângelo
AU - Hernández, Cristina
AU - Cunha-Vaz, José
AU - Simó, Rafael
N1 - © 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.
PY - 2017/9
Y1 - 2017/9
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85028088311&partnerID=8YFLogxK
UR - http://diabetes.diabetesjournals.org/content/66/9/2503
U2 - 10.2337/db16-1453
DO - 10.2337/db16-1453
M3 - Article
C2 - 28663190
SN - 0012-1797
VL - 66
SP - 2503
EP - 2510
JO - Diabetes
JF - Diabetes
IS - 9
ER -