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Subtle changes in diabetic retinas localised in 3D using OCT.

Edmund Arthur1, Joel A Papay1, Bryan P Haggerty1

  • 1Indiana University School of Optometry, Bloomington, USA.

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)
|July 28, 2018
PubMed
Summary
This summary is machine-generated.

Subtle retinal changes, including larger foveal avascular zones (FAZ) and thicker inner retinal layers (IRL) in diabetic patients, are detectable with Spectral Domain Optical Coherence Tomography (SD-OCT) even before clinical signs of diabetic retinopathy (DR). These findings suggest early neural tissue preservation despite potential ischemia.

Keywords:
diabetic macular oedemadiabetic retinopathyfoveal avascular zoneimagingoptical coherence tomographytransverse

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Diabetic Retinopathy Research

Background:

  • Diabetic retinopathy (DR) affects the retina, with early stages often showing no clinical signs.
  • Detecting subtle retinal changes is crucial for early intervention in diabetic patients.
  • Spectral Domain Optical Coherence Tomography (SD-OCT) offers high-resolution imaging of retinal layers.

Purpose of the Study:

  • To detect and localize subtle retinal changes in diabetic patients without clinically apparent diabetic retinopathy (DR) or with non-proliferative DR (NPDR).
  • To compare retinal layer thicknesses and foveal avascular zone (FAZ) size between diabetic patients and controls using SD-OCT.
  • To identify early structural alterations in the inner and outer retinal layers.

Main Methods:

  • 19 diabetic patients (16 no DR, 3 NPDR) and 19 age/sex-matched controls underwent macular SD-OCT.
  • En face images were generated to analyze FAZ size and retinal vessel caliber.
  • Inner retinal layer (IRLFAZ) and outer nuclear layer (ONLFAZ) thicknesses at the FAZ margins were measured.

Main Results:

  • Diabetic patients exhibited significantly larger FAZ areas (0.388 mm²) compared to controls (0.243 mm²).
  • The mean IRLFAZ was significantly thicker in diabetics (86.8 μm) than controls (65.2 μm).
  • Undetected retinal vessels and lesions in the photoreceptor layer were visualized in diabetic subjects.

Conclusions:

  • SD-OCT reveals early inner and outer retinal changes in diabetic patients not detectable by clinical examination.
  • Thicker IRLFAZ in diabetics suggests preserved neural mass despite potential ischemia, even in early stages.
  • These findings highlight the utility of SD-OCT for early detection of diabetic retinal alterations.