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Correlation between corneal and retinal neurodegenerative changes and their association with microvascular perfusion in type II diabetes
Author(s) -
Hafner Julia,
Karst Sonja,
Sacu Stefan,
Scholda Christoph,
Pablik Eleonore,
SchmidtErfurth Ursula
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13938
Subject(s) - ophthalmology , retinal , medicine , nerve fiber layer , retina , diabetic retinopathy , ganglion cell layer , microangiopathy , inner plexiform layer , diabetes mellitus , neuroscience , biology , endocrinology
Purpose The pathophysiology of diabetic neurodegeneration and microvasculopathy remains controversial. Neurosensory layer thickness and corneal nerve fibre loss represent potential biomarkers of neuropathy. The purpose of this cross‐sectional study was to determine the correlation between these neurodegenerative features and their association with retinal microvascular integrity in patients with type II diabetes without retinopathy. Methods Nerve fibre length ( NFL ), density ( NFD ) and branch density ( NBD ) were assessed using corneal confocal microscopy. Spectralis optical coherence tomography ( OCT ) was used for peripapillary retinal nerve fibre layer ( RNFL ), and macular RNFL , ganglion cell ( GCL ), inner plexiform ( IPL ) and inner nuclear layer ( INL ) thicknesses. Parafoveal vessel density ( PVD ) was determined using OCT angiography. Results We analysed 118 eyes of 61 patients. Peripapillary RNFL , macular RNFL , GCL , IPL and INL were 101 ± 8, 29 ± 3, 43 ± 4, 36 ± 3 and 36 ± 3 μ m. NFL , NFD and NBD were 12.3 ± 4.4 mm/mm 2 , 17.8 ± 7.4/mm 2 and 26.7 ± 15.2/mm 2 . Corneal nerve fibre variables were neither associated with inner retinal thicknesses nor PVD . A significant positive correlation was found between macular GCL , IPL and peripapillary RNFL with deep capillary plexus PVD (p ≤ 0.05). Conclusion Our results indicate that corneal and retinal neurodegeneration are independent changes early in type II diabetes and that distinct retinal, but not corneal neurodegenerative features, are associated with retinal microvascular perfusion.