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Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy

BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a specific subtype of diabetes with an uncertain impact on mortality and morbidity in post-transplant patients. Diabetic retinopathy is the most common microvascular complication of diabetes mellitus, but the long-term clinical progression in P...

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Autores principales: do Carmo Chaves, Anne Elise Cruz, Londero, Thizá Massaia, da Silva, Monica Oliveira, Lavinsky, Fábio, Leitão, Cristiane Bauermann, Bauer, Andrea Carla, Lavinsky, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463975/
https://www.ncbi.nlm.nih.gov/pubmed/37612660
http://dx.doi.org/10.1186/s40942-023-00487-4
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author do Carmo Chaves, Anne Elise Cruz
Londero, Thizá Massaia
da Silva, Monica Oliveira
Lavinsky, Fábio
Leitão, Cristiane Bauermann
Bauer, Andrea Carla
Lavinsky, Daniel
author_facet do Carmo Chaves, Anne Elise Cruz
Londero, Thizá Massaia
da Silva, Monica Oliveira
Lavinsky, Fábio
Leitão, Cristiane Bauermann
Bauer, Andrea Carla
Lavinsky, Daniel
author_sort do Carmo Chaves, Anne Elise Cruz
collection PubMed
description BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a specific subtype of diabetes with an uncertain impact on mortality and morbidity in post-transplant patients. Diabetic retinopathy is the most common microvascular complication of diabetes mellitus, but the long-term clinical progression in PTDM is unknown. New technologies are being used to assess pre-clinical signs of retinal changes, such as swept-source optical coherence tomography (OCT) and OCT-angiography. The aim of this study was to detect pre-clinical structural and vascular changes in the retina using swept-source-OCT and OCT-angiography in patients with PTDM. METHODS: In this retrospective cohort study, post-kidney transplant patients were divided into PTDM and non-PTDM (control) groups. Both eyes of eligible PTDM patients and controls were included in this study. Inner retinal layer thickness was measured with swept-source-OCT. Retinal capillary density and the foveal avascular zone were measured with OCT-angiography. RESULTS: In the PTDM group, reduced thickness was found in the inferior ganglion cell layer plus inner plexiform layer (95% CI -8.76 to -0.68; p = 0.022) and the temporal inferior segment (95% CI -10.23 to -0.76; p = 0.024) of the inner retina, as well as in the retinal nerve fiber layer in the temporal (95% CI -34.78 to -9.28 p = 0.001) and temporal inferior segments (95% CI -33.26 to -5.03 p = 0.008). No significant differences were found in the vascular capillary plexus between groups at all depths, segments, or foveal avascular zone (p = 0.088). CONCLUSIONS: According to OCT-angiography, PTDM patients had reduced inner neurosensory retinal layers but no significant change in vascular density, which suggests that early neuroretinal degeneration might occur prior to vascular changes secondary to PTDM. Prospective studies could help elucidate the clinical course of retinal neuropathy and microvascular pathology in PTDM and provide a better understanding of PTDM complications. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40942-023-00487-4.
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spelling pubmed-104639752023-08-30 Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy do Carmo Chaves, Anne Elise Cruz Londero, Thizá Massaia da Silva, Monica Oliveira Lavinsky, Fábio Leitão, Cristiane Bauermann Bauer, Andrea Carla Lavinsky, Daniel Int J Retina Vitreous Original Article BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a specific subtype of diabetes with an uncertain impact on mortality and morbidity in post-transplant patients. Diabetic retinopathy is the most common microvascular complication of diabetes mellitus, but the long-term clinical progression in PTDM is unknown. New technologies are being used to assess pre-clinical signs of retinal changes, such as swept-source optical coherence tomography (OCT) and OCT-angiography. The aim of this study was to detect pre-clinical structural and vascular changes in the retina using swept-source-OCT and OCT-angiography in patients with PTDM. METHODS: In this retrospective cohort study, post-kidney transplant patients were divided into PTDM and non-PTDM (control) groups. Both eyes of eligible PTDM patients and controls were included in this study. Inner retinal layer thickness was measured with swept-source-OCT. Retinal capillary density and the foveal avascular zone were measured with OCT-angiography. RESULTS: In the PTDM group, reduced thickness was found in the inferior ganglion cell layer plus inner plexiform layer (95% CI -8.76 to -0.68; p = 0.022) and the temporal inferior segment (95% CI -10.23 to -0.76; p = 0.024) of the inner retina, as well as in the retinal nerve fiber layer in the temporal (95% CI -34.78 to -9.28 p = 0.001) and temporal inferior segments (95% CI -33.26 to -5.03 p = 0.008). No significant differences were found in the vascular capillary plexus between groups at all depths, segments, or foveal avascular zone (p = 0.088). CONCLUSIONS: According to OCT-angiography, PTDM patients had reduced inner neurosensory retinal layers but no significant change in vascular density, which suggests that early neuroretinal degeneration might occur prior to vascular changes secondary to PTDM. Prospective studies could help elucidate the clinical course of retinal neuropathy and microvascular pathology in PTDM and provide a better understanding of PTDM complications. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40942-023-00487-4. BioMed Central 2023-08-23 /pmc/articles/PMC10463975/ /pubmed/37612660 http://dx.doi.org/10.1186/s40942-023-00487-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Article
do Carmo Chaves, Anne Elise Cruz
Londero, Thizá Massaia
da Silva, Monica Oliveira
Lavinsky, Fábio
Leitão, Cristiane Bauermann
Bauer, Andrea Carla
Lavinsky, Daniel
Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
title Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
title_full Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
title_fullStr Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
title_full_unstemmed Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
title_short Early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
title_sort early retinal neurovascular findings in post-transplant diabetes mellitus patients without clinical signs of diabetic retinopathy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10463975/
https://www.ncbi.nlm.nih.gov/pubmed/37612660
http://dx.doi.org/10.1186/s40942-023-00487-4
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