Functional and Structural Findings of Neurodegeneration in Early Stages of Diabetic Retinopathy. Cross-sectional Analyses of Baseline Data of the EUROCONDOR project

Santos, Ana Rita, Ribeiro, Luísa, Bandello, Francesco, Lattanzio, Rosangela, Egan, Catherine, Frydkjaer-Olsen, Ulrik, García-Arumí, José, Gibson, Jonathan, Grauslund DMSci, Jakob, Harding, Simon P, Lang, Gabriele E, Massin, Pascale, Midena, Edoardo, Scanlon, Peter H ORCID: 0000-0001-8513-710X, Aldington, Stephen J, Simão, Sílvia, Schwartz, Christian, Ponsati, Berta, Porta, Massimo, Costa, Miguel Ângelo, Hernández, Cristina, Cunha-Vaz, José and Simó, Rafael (2017) Functional and Structural Findings of Neurodegeneration in Early Stages of Diabetic Retinopathy. Cross-sectional Analyses of Baseline Data of the EUROCONDOR project. Diabetes, 66 (9). pp. 2503-2510. doi:10.2337/db16-1453

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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.

Item Type: Article
Article Type: Article
Additional Information: © American Diabetes Association (ADA). This is an author-created, un-copyedited electronic version of an article accepted for publication in 'Diabetes'. The American Diabetes Association (ADA), publisher of 'Diabetes', is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of 'Diabetes' in print and online at:
Uncontrolled Keywords: Diabetic retinopathy; Opthalmology
Related URLs:
Subjects: R Medicine > RA Public aspects of medicine > RA645.A-Z Individual diseases or groups of diseases, A-Z > RA645.D54 Diabetes
R Medicine > RE Ophthalmology
Divisions: Schools and Research Institutes > School of Education and Science
Research Priority Areas: Health, Life Sciences, Sport and Wellbeing
Depositing User: Anne Pengelly
Date Deposited: 15 Sep 2017 10:08
Last Modified: 31 Aug 2023 09:09

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