Assessment of optic disc and ganglion cell layer in diabetes mellitus type 2

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Abstract

The purpose of this study was to compare the optic disc parameters, retinal nerve fiber (RNFL), and macular ganglion cell layers between patients with diabetes mellitus (DM) type 2 and healthy controls.

In this cross-sectional study, 69 eyes of 69 diabetic patients without diabetic retinopathy and 47 eyes of 47 healthy controls were included. Optic disc parameters (i.e., rim area, disc area, cup to disc ratio, cup volume), RNFL, and macular ganglion cell-inner plexiform layers (GCL + IPL) thickness were measured by means of spectral domain optical coherence tomography.

There were not statistically significant differences between the diabetic patients and healthy controls in terms of RNFL thickness ( P = .32), rim area ( P = .20), disc area ( P = .16), cup volume ( P = .12), and average macular GCL + IPL thickness ( P = .11). Nevertheless, binocular RNFL thickness symmetry percentage ( P =.03), average cup to disc ratio ( P = .02), and superior-nasal macular GCL + IPL thickness ( P = .04) were statistically significantly different in the diabetic and control groups.

Diabetic patients without retinopathy have more binocular RNFL thickness asymmetry, higher cup to disc ratio, and thinner sectoral macular GCL + IPL when compared to healthy controls. Our results may support the statement that DM causes inner retinal neurodegenerative changes.

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Most cited references 15

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Automated 3-D intraretinal layer segmentation of macular spectral-domain optical coherence tomography images.

Michael D. Abramoff, S. Russell, Milan Sonka … (2009)

With the introduction of spectral-domain optical coherence tomography (OCT), much larger image datasets are routinely acquired compared to what was possible using the previous generation of time-domain OCT. Thus, the need for 3-D segmentation methods for processing such data is becoming increasingly important. We report a graph-theoretic segmentation method for the simultaneous segmentation of multiple 3-D surfaces that is guaranteed to be optimal with respect to the cost function and that is directly applicable to the segmentation of 3-D spectral OCT image data. We present two extensions to the general layered graph segmentation method: the ability to incorporate varying feasibility constraints and the ability to incorporate true regional information. Appropriate feasibility constraints and cost functions were learned from a training set of 13 spectral-domain OCT images from 13 subjects. After training, our approach was tested on a test set of 28 images from 14 subjects. An overall mean unsigned border positioning error of 5.69+/-2.41 microm was achieved when segmenting seven surfaces (six layers) and using the average of the manual tracings of two ophthalmologists as the reference standard. This result is very comparable to the measured interobserver variability of 5.71+/-1.98 microm.

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Early detection of retinal thickness changes in diabetes using Optical Coherence Tomography.

Gábor Somfai, Delia Debuc (2010)

Diabetic Retinopathy (DR) is a severe and widely spread eye disease. Thus, an objective test for the early diagnosis and evaluation of treatment in DR is certainly needed. In this study, the ability of intraretinal layer segmentation to locally detect early retinal changes in diabetic patients is assessed using optical coherence tomography (OCT). Fifty diabetic patients with no or minimal DR underwent ophthalmic examination, OCT and fundus photography. Automated segmentation of intraretinal layers of the OCT images was performed using a custom-built algorithm. Mean thickness of the macula and intraretinal layers of patients with no DR (DM) was calculated in the fovea, pericentral and peripheral regions and compared with those in patients with mild DR (MDR). We found reduced retinal nerve fiber layer (RNFL) thickness in the pericentral and peripheral regions (27 + or - 2 versus 18 + or - 5 microm and 42 + or - 3 versus 33 + or - 9 microm, respectively, p<0.001) and reduced thickness of ganglion cell/inner plexiform layer (GCL+IPL) complex in the pericentral region of the macula (92 + or - 7 microm versus 80 + or - 10 microm, p<0.001) in the MDR group. Accordingly, macular thickness was reduced in the pericentral and peripheral region of the macula in the MDR group. Our results support the view of neurodegeneration in diabetes in the early stage of retinopathy which seems to involve the ganglion cells and cells of the inner plexiform layers (RNFL+GCL+IPL) mostly. Local retinal thickness measures can be obtained from OCT scans using an intraretinal layer segmentation procedure, and these measures could be helpful in finding a surrogate for following development of retinopathy that could affect vision.

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Mitochondria- and caspase-dependent cell death pathway involved in neuronal degeneration in diabetic retinopathy.

S Roy, T Oshitari, N Hata … (2008)

Neuronal abnormalities are associated with the pathogenesis of diabetic retinopathy. However, the mechanisms for neuronal cell death in diabetic retinopathy remain unclear. To determine whether altered expression of Bax, caspase-9 and -3 is associated with degenerative neurons in diabetic retinopathy. Immunohistochemistry was performed on cryosections obtained from five pairs of normal and five pairs of age-matched diabetic human retinas. Diabetic eyes had no proliferative diabetic retinopathy and no histories of photocoagulation or ocular surgery. In this study, Fluoro-Jade B (FJB) was used as a marker for identification of degenerative neurons. In diabetic retinas, Bax overexpression coexisted with FJB positive signals in the ganglion cell layer (GCL) compared with very low FJB levels in the normal retina. Increased level of the active forms of caspase-9 and -3 expressions coexisted with FJB positive cells in the GCL of diabetic retinas compared with those in normal retinas. Upregulation of Bax, caspase-9 and -3 expression was associated with neuronal degeneration in diabetic retinopathy. The mitochondria- and caspase-dependent cell-death pathway may be, in part, associated with neuronal degeneration in diabetic retinas.

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Author and article information

Journal

Journal ID (nlm-ta): Medicine (Baltimore)

Journal ID (iso-abbrev): Medicine (Baltimore)

Journal ID (publisher-id): MEDI

Title: Medicine

Publisher: Wolters Kluwer Health

ISSN (Print): 0025-7974

ISSN (Electronic): 1536-5964

Publication date Collection: July 2017

Publication date (Electronic): 21 July 2017

Volume: 96

Issue: 29

Electronic Location Identifier: e7556

Affiliations

[a ]Denizli State Hospital, Eye Clinic

[b ]Ophthalmology Department, Pamukkale University, Denizli, Turkey.

Author notes

[∗ ]Correspondence: Gökhan Pekel, Ophthalmology Department, Pamukkale University, Denizli 20070, Turkey (e-mail: gkhanpekel@ 123456yahoo.com ).

Article

Publisher ID: MD-D-17-02675 Accession ID: 07556

DOI: 10.1097/MD.0000000000007556

PMC ID: 5521921

PubMed ID: 28723781

SO-VID: 8b5c0ef0-4ba0-4f2a-a255-34c22b5bd0a0

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This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0

History

Date received : 28 April 2017

Date revision received : 25 June 2017

Date accepted : 27 June 2017

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Keywords: diabetes mellitus,hba1c,macular ganglion cell layer,optic disc,retinal nerve fiber layer

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Keywords: diabetes mellitus, hba1c, macular ganglion cell layer, optic disc, retinal nerve fiber layer

Assessment of optic disc and ganglion cell layer in diabetes mellitus type 2

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Most cited references 15

Automated 3-D intraretinal layer segmentation of macular spectral-domain optical coherence tomography images.

Early detection of retinal thickness changes in diabetes using Optical Coherence Tomography.

Mitochondria- and caspase-dependent cell death pathway involved in neuronal degeneration in diabetic retinopathy.

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