Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
| Autor: | Thomas W. Gardner, Vinicius M. de Castro, Rohit Anand, Chris A. Johnson, Katherine A. Joltikov, Neil Farbman, Gregory R. Jackson, Jose R. Davila, Sami M. Khan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Visual acuity media_common.quotation_subject retinal neurodegeneration Visual Acuity Retina 03 medical and health sciences Young Adult 0302 clinical medicine Pattern standard deviation structure-function analysis Ophthalmology Diabetes mellitus medicine Contrast (vision) Humans media_common contrast sensitivity Analysis of Variance Diabetic Retinopathy medicine.diagnostic_test business.industry Special Issue Fundus photography Diabetic retinopathy Middle Aged medicine.disease Frequency doubling perimetry eye diseases 3. Good health 030104 developmental biology medicine.anatomical_structure OCT Case-Control Studies Sensory Thresholds 030221 ophthalmology & optometry visual fields Visual Field Tests Female sense organs medicine.symptom business Tomography Optical Coherence |
| Zdroj: | Investigative Ophthalmology & Visual Science |
| ISSN: | 1552-5783 0146-0404 |
| Popis: | Purpose To test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease. Methods Fifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild nonproliferative diabetic retinopathy [mild NPDR], 15 with moderate to severe [moderate NPDR]), and 18 controls underwent full ophthalmic examination, fundus photography, spectral-domain optical coherence tomography (SD-OCT), e-ETDRS (Early Treatment Diabetic Retinopathy Study) acuity, and the quick contrast sensitivity function (qCSF) method. Perimetry testing included short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), frequency doubling perimetry (FDP), and rarebit perimetry (RBP). Results ETDRS acuity and RBP were not sensitive for functional differences among subjects with diabetes. AULCSF, a metric of qCSF, was reduced in diabetics with moderate compared to mild NPDR (P = 0.03), and in subjects with no DR compared to controls (P = 0.04). SWAP and SAP mean deviation (MD) and foveal threshold (FT) were reduced in moderate compared to mild NPDR (SWAP, MD P = 0.002, FT P = 0.0006; SAP, MD P = 0.02, FT P = 0.007). FDP 10-2 showed reduced MD in moderate compared to mild NPDR (P = 0.02), and FDP 24-2 revealed reduced pattern standard deviation (PSD) in mild NPDR compared to no DR (P = 0.02). Structural analysis revealed thinning of the ganglion cell layer and inner plexiform layer (GCL+IPL) of moderate NPDR subjects compared to controls. The thinner GCL+IPL correlated with impaired retinal function. Conclusions This multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies. |
| Databáze: | OpenAIRE |
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