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Retinal Nerve and Vascular Changes in Prediabetes.

Rui Ping Peng1, Zi Qian Zhu1, Hong Yi Shen1

  • 1Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

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Prediabetes is linked to thinner retinal nerve fiber layers and reduced macular thickness, even without visible microvascular changes. These findings suggest early neuroretinal damage occurs before microvascular injury in prediabetes.

Keywords:
impaired fasting glucoseimpaired glucose tolerance (IGT)microvascular injurynerve fiber layerprediabetes

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Area of Science:

  • Ophthalmology
  • Diabetology
  • Neuroscience

Background:

  • Prediabetes, characterized by impaired fasting glucose (IFG) and impaired glucose tolerance (IGT), represents a critical stage before type 2 diabetes.
  • Early detection of complications in prediabetes is crucial for timely intervention.
  • Neuroretinal and vascular changes in the eye can serve as indicators of systemic metabolic health.

Purpose of the Study:

  • To investigate vascular and neuroretinal alterations in individuals with prediabetes compared to those with normal glucose metabolism.
  • To determine if prediabetes is associated with early ocular changes, preceding microvascular damage.

Main Methods:

  • A comparative study involving 21 prediabetic patients and 20 healthy controls.
  • Comprehensive eye examinations including fundus fluorescein angiography (FFA) and optical coherence tomography (OCT).
  • General health assessments including biochemical analysis and glycosylated hemoglobin levels.

Main Results:

  • No microvascular alterations were observed in either group via FFA.
  • Prediabetic individuals exhibited significantly thinner total peripapillary retinal nerve fiber layer (pRNFL) and temporal pRNFL compared to controls.
  • Reduced macular retinal thickness was noted in prediabetics within a 6 mm diameter in nasal, superior, temporal, and inferior sectors.

Conclusions:

  • Prediabetes is associated with significant neuroretinal thinning (total and temporal pRNFL) and reduced macular thickness.
  • These neuroretinal alterations occur in the absence of detectable microvascular changes.
  • The study confirms that neuroretinal damage may precede microvascular injury in prediabetes, highlighting the eye as an early diagnostic site.