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, Jakob, Harding, Simon P., Lang, Gabriele E., Massin, Pascale, Midena, Edoardo, Scanlon, Peter, Aldington, Stephen J., Simão, Sílvia, Schwartz, Christian, Ponsati, Berta, Porta, Massimo, Costa, Miguel Ângelo, Hernández, Cristina, Cunha-Vaz, José, Simó, Rafael and , European Consortium for the Early Treatment of Diabetic Retinopa (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.

Abstract

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.

Publication DOI: https://doi.org/10.2337/db16-1453
Divisions: Life & Health Sciences > Ophthalmic Research Group
Life & Health Sciences
Life & Health Sciences > Optometry
Additional Information: © 2017 by the American Diabetes Association. http://www.diabetesjournals.org/content/license Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.
Uncontrolled Keywords: Internal Medicine,Endocrinology, Diabetes and Metabolism
Full Text Link: http://livrepository.liverpool.ac.uk/id/eprint/3010828
Related URLs: http://www.scopus.com/inward/record.url?scp=85028088311&partnerID=8YFLogxK (Scopus URL)
http://diabetes.diabetesjournals.org/content/66/9/2503 (Publisher URL)
Published Date: 2017-09
Authors: Santos, Ana Rita
Ribeiro, Luísa
Bandello, Francesco
Lattanzio, Rosangela
Egan, Catherine
Frydkjaer-Olsen, Ulrik
García-Arumí, José
Gibson, Jonathan ( 0000-0002-9281-5244)
Grauslund, Jakob
Harding, Simon P.
Lang, Gabriele E.
Massin, Pascale
Midena, Edoardo
Scanlon, Peter
Aldington, Stephen J.
Simão, Sílvia
Schwartz, Christian
Ponsati, Berta
Porta, Massimo
Costa, Miguel Ângelo
Hernández, Cristina
Cunha-Vaz, José
Simó, Rafael
, European Consortium for the Early Treatment of Diabetic Retinopa

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