Abstract
To evaluate macular thickness in eyes with mild nonproliferative diabetic retinopathy (NPDR), patients with diabetes type 2, NPDR level 20 or 35, and without evidence of clinical macular edema underwent best-corrected visual acuity assessment, color fundus photography and Stratus optical coherence tomography. Mean center point thickness (CPT) and mean central subfield (CSF) thickness were compared with those of a healthy control population. 410 eyes/patients aged 61.2 ± 8.3 years, and with glycosylated hemoglobin of 7.9 ± 1.5% were included. Mean CPT and CSF were 186.6 ± 28.4 and 215.2 ± 25 µm, respectively, significantly increased compared to healthy subjects (p < 0.001). CSF thickness was abnormally increased in 17.6% of the patients, with values within the normal range in 79.5%, and abnormally decreased in 2.9%. CPT and CSF thickness were significantly thicker in men. No systemic factors showed a significant association. A significant increase in the macular thickness was found in eyes/patients with mild NPDR without clinical macular edema; however, only 17.6% of the eyes/patients had abnormally increased values and less than 3% abnormally decreased values.
References
1.
Klein R, Klein BE, Moss SE, Linton KL: The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and previously diagnosed diabetes mellitus. Ophthalmology 1992;99:58-62.
2.
Aiello LP, Gardner TW, King GL, Blankenship G, Cavallerano JD, Ferris FL III, Klein R: Diabetic retinopathy. Technical Review. Diabetes Care 1998;21:143-156.
3.
Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol 1985;103:1796-1806.
4.
Brown JC, Solomon SD, Bressler SB, Schachat AP, DiBernardo C, Bressler NM: Detection of diabetic foveal edema: contact lens biomicroscopy compared with optical coherence tomography. Arch Ophthalmol 2004;122:330-335.
5.
Sadda SR, Tan O, Walsh AC, Schuman JS, Varma R, Huang D: Automated detection of clinically significant macular edema by grid scanning optical coherence tomography. Ophthalmology 2006;113:1187.
6.
Hee MR, Puliafito CA, Duker JS, Reichel E, Coker JG, Wilkins JR, Schuman JS, Swanson EA, Fujimoto JG: Topography of diabetic macular edema with optical coherence tomography. Ophthalmology 1998;105:360-370.
7.
Massin P, Erginay A, Haouchine B, Mehidi AB, Paques M, Gaudric A: Retinal thickness in healthy and diabetic subjects measured using optical coherence tomography mapping software. Eur J Ophthalmol 2002;12:102-108.
8.
Sánchez-Tocino H, Alvarez-Vidal A, Maldonado MJ, Moreno-Montañés J, García-Layana A: Retinal thickness study with optical coherence tomography in patients with diabetes. Invest Ophthalmol Vis Sci 2002;43:1588-1594.
9.
Lattanzio R, Brancato R, Pierro L, Bandello F, Iaccher B, Fiore T, Maestranzi G: Macular thickness measured by optical coherence tomography (OCT) in diabetic patients. Eur J Ophthalmol 2002;12:482-487.
10.
Yang CS, Cheng CY, Lee FL, Hsu WM, Liu JH: Quantitative assessment of retinal thickness in diabetic patients with and without clinically significant macular edema using optical coherence tomography. Acta Ophthalmol Scand 2001;79:266-270.
11.
Browning DJ, McOwen MD, Bowen RM Jr, O'Marah TL: Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography. Ophthalmology 2004;111:712-715.
12.
Paunescu LA, Schuman JS, Price LL, Stark PC, Beaton S, Ishikawa H, Wollstein G, Fujimoto JG: Reproducibility of nerve fiber thickness, macular thickness, and optic nerve head measurements using Stratus OCT. Invest Ophthalmol Vis Sci 2004;45:1716-1724.
13.
Massin P, Vicaut E, Haouchine B, et al: Reproducibility of retinal mapping using optical coherence tomography. Arch Ophthalmol 2001;119:1135-1142.
14.
Diabetic Retinopathy Clinical Research Network, Krzystolik MG, Strauber SF, Aiello LP, Beck RW, Berger BB, Bressler NM, Browning DJ, Chambers RB, Danis RP, Davis MD, Glassman AR, Gonzalez VH, Greenberg PB, Gross JG, Kim JE, Kollman C: Reproducibility of macular thickness and volume using Zeiss optical coherence tomography in patients with diabetic macular edema. Ophthalmology 2007;114:1520-1525.
15.
Puliafito CA, Hee MR, Lin CP, Reichel E, Schuman JS, Duker JS, Izatt JA, Swanson EA, Fujimoto JG: Imaging of macular diseases with optical coherence tomography. Ophthalmology 1995;102:217-229.
16.
Oshitari T, Hanawa K, Adachi-Usami E: Changes of macular and RNFL thicknesses measured by Stratus OCT in patients with early stage diabetes. Eye (Lond) 2009;23:884-889.
17.
Asefzadeh B, Fisch BM, Parenteau CE, Cavallerano AA: Macular thickness and systemic markers for diabetes in individuals with no or mild diabetic retinopathy. Clin Experiment Ophthalmol 2008;36:455-463.
18.
Bressler NM, Edwards AR, Antoszyk AN, Beck RW, Browning DJ, Ciardella AP, Danis RP, Elman MJ, Friedman SM, Glassman AR, Gross JG, Li HK, Murtha TJ, Stone TW, Sun JK, Diabetic Retinopathy Clinical Research Network: Retinal thickness on Stratus optical coherence tomography in people with diabetes and minimal or no diabetic retinopathy. Am J Ophthalmol 2008;145:894-901.
19.
Kashani AH, Zimmer-Galler IE, Shah SM, Dustin L, Do DV, Eliott D, Haller JA, Nguyen QD: Retinal thickness analysis by race, gender, and age using Stratus OCT. Am J Ophthalmol 2010;149:496-502.
20.
Sng CC, Cheung CY, Man RE, Wong W, Lavanya R, Mitchell P, Aung T, Wong TY: Influence of diabetes on macular thickness measured using optical coherence tomography: the Singapore Indian Eye Study. Eye (Lond) 2012;26:690-698.
21.
Wong AC, Chan CW, Hui SP: Relationship of gender, body mass index, and axial length with central retinal thickness using optical coherence tomography. Eye (Lond) 2005;19:292-297.
22.
Duan XR, Liang YB, Friedman DS, Sun LP, Wong TY, Tao QS, Bao L, Wang NL, Wang JJ: Normal macular thickness measurements using optical coherence tomography in healthy eyes of adult Chinese persons: the Handan Eye Study. Ophthalmology 2010;117:1585-1594.
23.
Huang J, Liu X, Wu Z, Xiao H, Dustin L, Sadda S: Macular thickness measurements in normal eyes with time-domain and Fourier-domain optical coherence tomography. Retina 2009;29:980-987.
24.
Browning DJ, Fraser CM, Clark S: The relationship of macular thickness to clinically graded diabetic retinopathy severity in eyes without clinically detected diabetic macular edema. Ophthalmology 2008;115:533-539.
25.
Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7. Ophthalmology 1991;98(suppl 5):741-756.
26.
Patella VM: Stratus OCT: establishment of normative reference values for retinal nerve fiber layer thickness. Carl Zeiss Meditec Web site. ccesshttp://www.zeiss.com/C1256C4F002FF302/EmbedTitelIntern/StratusOCT/$File/OCT%20Normative%20Database%20Paper.pdf (accessed February 28, 2013).
27.
Stratus OCT™ Reference Manual. Carl Zeiss Meditec Web site. http://www.meditec.zeiss.com/88256DE3007B916B/0/55B63359D850E15D882575E7000AA4AE/$file/stratusoct5_en.pdf (accessed February 28, 2013).
28.
Grover S, Murthy RK, Brar VS, Chalam KV: Comparison of retinal thickness in normal eyes using Stratus and Spectralis optical coherence tomography. Invest Ophthalmol Vis Sci 2010;51:2644-2647.
29.
Chan A, Duker JS, Ko TH, Fujimoto JG, Schuman JS: Normal macular thickness measurements in healthy eyes using Stratus optical coherence tomography. Arch Ophthalmol 2006;124:193-198.
30.
UK Prospective Diabetes Study (UKPDS) Group: Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-853.
31.
Klein R, Klein BE, Moss SE, Cruickshanks KJ: Relationship of hyperglycemia to the long-term incidence and progression of diabetic retinopathy. Arch Intern Med 1994;154:2169-2178.
32.
Matthews DR, Stratton IM, Aldington SJ, Holman RR, Kohner EM, UK Prospective Diabetes Study Group: Risks of progression of retinopathy and vision loss related to tight blood pressure control in type 2 diabetes mellitus: UKPDS 69. Arch Ophthalmol 2004;122:1631-1640.
33.
Kohner EM, Aldington SJ, Stratton IM, Manley SE, Holman RR, Matthews DR, Turner RC: United Kingdom Prospective Diabetes Study. 30. Diabetic retinopathy at diagnosis of non-insulin-dependent diabetes mellitus and associated risk factors. Arch Ophthalmol 1998;116:297-303.
34.
Benarous R, Sasongko MB, Qureshi S, Fenwick E, Dirani M, Wong TY, Lamoureux EL: Differential association of serum lipids with diabetic retinopathy and diabetic macular edema. Invest Ophthalmol Vis Sci 2011;52:7464-7469.
35.
Klein BE, Moss SE, Klein R, Surawicz TS: Serum cholesterol in Wisconsin Epidemiologic Study of Diabetic Retinopathy. Diabetes Care 1992;15:282-287.
36.
Klein BE, Moss SE, Klein R, Surawicz TS: The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XIII. Relationship of serum cholesterol to retinopathy and hard exudate. Ophthalmology 1991;98:1261-1265.
37.
Diabetic Retinopathy Clinical Research Network, Bressler NM, Miller KM, Beck RW, Bressler SB, Glassman AR, Kitchens JW, Melia M, Schlossman DK: Observational study of subclinical diabetic macular edema. Eye (Lond) 2012;26:833-840.
38.
Cunha-Vaz J, Bernardes R, Lobo C: Blood-retinal barrier. Eur J Ophthalmol 2011;21 (suppl 6):S3-S9.
39.
Biallosterski C, van Velthoven ME, Michels RP, Schlingemann RO, De Vries JH, Verbraak FD: Decreased optical coherence tomography-measured pericentral retinal thickness in patients with diabetes mellitus type 1 with minimal diabetic retinopathy. Br J Ophthalmol 2007;91:1135-1138.
40.
Van Dijk HW, Verbraak FD, Kok PH, Garvin MK, Sonka M, Lee K, De Vries JH, Michels RP, van Velthoven ME, Schlingemann RO, Abràmoff MD: Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes. Invest Ophthalmol Vis Sci 2010;51:3660-3665.
41.
Van Dijk HW, Verbraak FD, Kok PH, Stehouwer M, Garvin MK, Sonka M, De Vries JH, Schlingemann RO, Abràmoff MD: Early neurodegeneration in the retina of type 2 diabetic patients. Invest Ophthalmol Vis Sci 2012;53:2715-2719.
© 2013 S. Karger AG, Basel
2013
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