Relationship of Peripapillary Retinal Perfusion with Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetes Mellitus Patients without Diabetic Retinopathy

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Published Sep 21, 2021
DOI: https://doi.org/10.35479/ijretina.2021.vol004.iss002.161

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Sindi Dwijayanti
Cicendo National Eye Hospital, Bandung, Indonesia
Irawati Irfani
Pediatric Ophthalmology and Strabismus Division, Cicendo National Eye Hospital, Bandung, Indonesia
Susanti Natalya Sirait
Refraction, contact lens, and low vision Division, Cicendo National Eye Hospital, Bandung, Indonesia
Elsa Gustianty
Glaucoma Division, Cicendo National Eye Hospital, Bandung, Indonesia
Erwin Iskandar
Vitreoretina Division, Cicendo National Eye Hospital, Bandung, Indonesia
R. Angga Kartiwa
Reconstruction, Oculoplasty, and Oncology Division, Cicendo National Eye Hospital, Bandung, Indonesia

Abstract

Introduction: Impaired blood flow is an early sign of retinal dysfunction in diabetes. Impaired blood flow of the radial peripapillary capillaries can affect the Retinal Nerve Fiber Layer (RNFL) or ganglion cell function.


Methods: This was an analytic cross-sectional study in February-April 2019 at Bandung. The subjects of this study were 41 people (79 eyes) divided into two groups, group A (healthy subjects) 19 people (37 eyes) and group B (DM type 2 without diabetic retinopathy) 22 people (42 eyes). Peripapillary retinal perfusion was assesed using OCT Angiography and RNFL thickness was assesed using OCT. Pearson or Spearman correlation statistics test was used to analyze the result. P value ≤0.05 was consiedered significant.


Results: There was a decrease in peripapillary retinal perfusion density in the inferior quadrant (P = 0.003) and flux index throughout the peripapillary retinal quadrant (P = 0.0001) but an increase in RNFL thickness in the peripapillary temporal quadrant (P = 0.012) compared to control grup. Positive correlation was found between peripapillary retinal perfusion density and RNFL thickness globally (r = 0.480, P = 0.001), superior quadrant (r = 0.436, P = 0.004), and inferior quadrant (r = 0.608, P = 0.000). A positive correlation was also found between the peripapillary flux and RNFL thickness globally (r = 0.517, P = 0.000), superior quadrant (r = 0.630, P = 0.000), and inferior quadrant (r = 0.519, P = 0.000).


Conclusions: There was a relationship between peripapillary retinal perfusion and RNFL thickness in DM patients without diabetic retinopathy.


Keywords: Peripapillary perfusion, RNFL thickness, Diabetes.

Keywords

peripapillary perfusion, RNFL thickness, diabetes mellitus type 2

Article Details

How to Cite
DWIJAYANTI, Sindi et al. Relationship of Peripapillary Retinal Perfusion with Peripapillary Retinal Nerve Fiber Layer Thickness in Diabetes Mellitus Patients without Diabetic Retinopathy. International Journal of Retina, [S.l.], v. 4, n. 2, p. 119, sep. 2021. ISSN 2614-8536. Available at: <https://ijretina.com/index.php/ijretina/article/view/161>. Date accessed: 12 dec. 2024. doi: https://doi.org/10.35479/ijretina.2021.vol004.iss002.161.
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Issue
Vol 4 No 2 (2021): International Journal of Retina (IJRetina) - INAVRS
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Research Articles
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References

1. International Council of Ophthalmology. Update 2017 ICO Guidelines for Diabetic Eye Care. Int Counc Ophthalmol. 2017;1–34.
2. Flaxman SR, Bourne RR, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV, Das A, Jonas JB, Keeffe J, Kempen JH, Leasher J. Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. The Lancet Global Health. 2017;5(12):e1221-34.
3. Didik Budijanto, Rudy Kurniawan, Kurniasih N, Khairani. InfoDatin : Hari Diabetes Sedunia tahun 2018. Kementeri Kesehat RI Pus Data Dan Inf. 2018;1–8.
4. American Academy of Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern®Guidelines. Diabetic Retinopathy. San Francisco, CA: American Academy of Ophthalmology; 2017.
5. Sasongko MB, Widyaputri F, Agni AN, Wardhana FS, Kotha S, Gupta P, Widayanti TW, Haryanto S, Widyaningrum R, Wong TY, Kawasaki R. Prevalence of diabetic retinopathy and blindness in Indonesian adults with type 2 diabetes. American journal of ophthalmology. 2017;181:79-87.
6. Gardner TW, Davila JR. The neurovascular unit and the pathophysiologic basis of diabetic retinopathy. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2017;255(1):1-6.
7. Lechner J, O’leary OE, Stitt AW. The pathology associated with diabetic retinopathy. Vision research. 2017;139:7-14.
8. Chen X, Nie C, Gong Y, Zhang Y, Jin X, Wei S, Zhang M. Peripapillary retinal nerve fiber layer changes in preclinical diabetic retinopathy: a meta-analysis. PloS one. 2015;10(5):e0125919.
9. Liu L, Wang Y, Liu HX, Gao J. Peripapillary Region Perfusion and Retinal Nerve Fiber Layer Thickness Abnormalities in Diabetic Retinopathy Assessed by OCT Angiography. Translational vision science & technology. 2019;8(4):1-9.
10. She X, Guo J, Liu X, Zhu H, Li T, Zhou M, Wang F, Sun X. Reliability of vessel density measurements in the peripapillary retina and correlation with retinal nerve fiber layer thickness in healthy subjects using optical coherence tomography angiography. Ophthalmologica. 2018;240(4):183-90.
11. American Academy of Ophthalmology. Basic and Clinical Science Course : Retina and Vitreous. American Academy of Ophthalmology; 2016.
12. Nadia K. Waheed, Amir H. Kashani, Carlos Alexandre de Amorim Garcia Filho, Jay S. Duker, Philip J. Rosenfeld. Retinal Imaging and Diagnostics : Optical Coherence Tomography. In: Ryan’s Retina. edisi 6. China: Elsevier Inc; 2018. 77–9, 102–6.
13. Mihardja L, Soetrisno U, Soegondo S. Prevalence and clinical profile of diabetes mellitus in productive aged urban Indonesians. Journal of diabetes investigation. 2014;5(5):507-12.
14. Li Z, Wen X, Zeng P, Liao Y, Fan S, Zhang Y, Li Y, Xiao J, Lan Y. Do microvascular changes occur preceding neural impairment in early-stage diabetic retinopathy? Evidence based on the optic nerve head using optical coherence tomography angiography. Acta diabetologica. 2019;56(5):531-9.
15. Shin YI, Nam KY, Lee SE, Lee MW, Lim HB, Jo YJ, Kim JY. Peripapillary microvasculature in patients with diabetes mellitus: an optical coherence tomography angiography study. Scientific reports. 2019;9(1):1-0.
16. Rodrigues TM, Marques JP, Soares M, Dolan MJ, Melo P, Simão S, Teles J, Figueira J, Murta JN, Silva R. Peripapillary neurovascular coupling in the early stages of diabetic retinopathy. Retina. 2019;39(12):2292-302.
17. Cao D, Yang D, Yu H, Xie J, Zeng Y, Wang J, Zhang L. Optic nerve head perfusion changes preceding peripapillary retinal nerve fibre layer thinning in preclinical diabetic retinopathy. Clinical & experimental ophthalmology. 2019;47(2):219-25.
18. Mehboob MA, Amin ZA, Islam QU. Comparison of retinal nerve fiber layer thickness between normal population and patients with diabetes mellitus using optical coherence tomography. Pakistan Journal of Medical Sciences. 2019;35(1):29.
19. Araszkiewicz A, Zozulinska-Ziolkiewicz D. Retinal Neurodegeneration in the Course of Diabetes-Pathogenesis and Clinical Perspective. Bentham Sci Publ. 2016;14:805–9.
20. Vujosevic S, Midena E. Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations. Hindawi Publ Corp. 2013;2013:1–8.
21. Mase T, Ishibazawa A, Nagaoka T, Yokota H, Yoshida A. Radial peripapillary capillary network visualized using wide-field montage optical coherence tomography angiography. Investigative ophthalmology & visual science. 2016;57(9):504-10.
22. Hafner J, Ginner L, Karst S, Leitgeb R, Unterluggauer M, Sacu S, Mitsch C, Scholda C, Pablik E, Schmidt-Erfurth U. Regional patterns of retinal oxygen saturation and microvascular hemodynamic parameters preceding retinopathy in patients with type II diabetes. Investigative ophthalmology & visual science. 2017;58(12):5541-7.