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Study looks at retinal diabetic neurodegeneration and progression of diabetic retinopathy in type 2 diabetes

By Editor
14th September 2018
Diabetic retinopathy, Research

Progressive loss of macular ganglion cell-inner plexiform layer (mGCIPL) is an independent risk factor for progression in early-stage diabetic retinopathy (DR), a study has concluded.

Researchers from Kyung Hee University Medical Center investigated the longitudinal relationship between diabetic retinal neurodegeneration and the progression of diabetic retinopathy.

They measured macular ganglion cell-inner plexiform layer (mGCIPL) thickness in patients with type 2 diabetes in the study published by The American Journal of Ophthalmology.

People with type 2 diabetes without DR or mild nonproliferative DR (NPDR) followed up for 4-plus years. DR was graded according to retinal photography, and mean parafoveal mGCIPL thickness was measured using optical coherence tomography with at least a 6-month interval from baseline. Hazard ratios (HR) for predicting two-step progression and development of proliferative DR (PDR) were calculated using Cox proportional hazard modeling using baseline clinical factors.

Summarising the results, the research team said: “Of 87 eyes of T2DM patients, 39 (44.8%) exhibited two-step DR progression and 6 (6.9%) experienced progression to PDR. Patients with DR progression exhibited longer T2DM duration, thinner mGCIPL, greater mGCIPL thinning rate, severe cardiac autonomic neuropathy (CAN), lower peripheral nerve-conduction velocity, and higher glycated hemoglobin A1c level.

“Multivariate regression modeling revealed that baseline mGCIPL thickness (HR=0.94), mGCIPL thinning rate (HR = 1.924), CAN score (HR = 1.248), and conduction velocity of peripheral nerves (HR=0.894) were significant predictive factors for DR progression (area under the curve = 0.92).”

The researchers concluded: “Progressive loss of mGCIPL is an independent risk factor for progression in early-stage DR. Further assessment of autonomic and peripheral nerve functions can increase sensitivity in predicting aggravation of DR in patients with T2DM [type 2 diabetes].”

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