Study Of Retinal Nerve Fibre Layer Thickness In Patients With Early Diabetes Mellitus

IntroductionDiabetic retinopathy(DR)is one of the leading causes that result in adult legal blindness in many countries.Recent researches suggest that neurodegeneration of the retinal nerve is an important component of DR.To realize the multiple processes of the disease of retinal neutron is very important for prevention and treatment on DR.Diabetic retina undergoes degenerative changes in retinal nerve fiber layer(RNFL)in addition to vascular changes.Loss of RNFL with changes in inner retina and their association with metabolic control have been studied with varied results in diabetic patients.AimTo compare the RNFL thickness between diabetic patients and age matched healthy controls and to correlate the thickness to metabolic control.Materials and MethodsOne hundred and sixty five patients were enrolled in Mount Tai medical school affliated hospital in the study out of which 50 served as normal healthy controls,58 patients were diabetic without retinopathy and 57 patients had diabetic retinopathy.Both eyes of all patients underwent optical coherence tomography scans for RNFL and ganglion cell complex.Foveal and parafoveal thickness were also measured.All the parameters were compared to patient's metabolic control.ResultsRNFL thinning was observed in superotemporal(p-value = 0.001)and upper nasal sectors(p-value = 0.031)around the optic disc in eyes with diabetic retinopathy.Ganglion cell complex also showed statistically significant thinning in diabetic patients.Creatinine levels showed a weak negative correlation to the RNFL.ConclusionThis study positively concluded that neurodegeneration in an early component of diabetic retinopathy.The decline of the RNFL thickness in patients with type 2 diabetes appears to be prior to the diagnosis of DR.