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Does Retinal Neurodegeneration Seen in Diabetic Patients Begin in the Insulin Resistance Stage?

OBJECTIVES: To investigate whether retinal neurodegeneration and impairment in contrast sensitivity (CS), which have been demonstrated to begin in diabetic patients before the presence of signs of diabetic retinal vasculopathy, also occur in the stage of insulin resistance. MATERIALS AND METHODS: Th...

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Detalles Bibliográficos
Autores principales: Arıkan, Sedat, Erşan, İsmail, Eroğlu, Mustafa, Yılmaz, Mehmet, Tufan, Hasan Ali, Gencer, Baran, Kara, Selçuk, Aşık, Mehmet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Galenos Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5177782/
https://www.ncbi.nlm.nih.gov/pubmed/28050322
http://dx.doi.org/10.4274/tjo.68888
Descripción
Sumario:OBJECTIVES: To investigate whether retinal neurodegeneration and impairment in contrast sensitivity (CS), which have been demonstrated to begin in diabetic patients before the presence of signs of diabetic retinal vasculopathy, also occur in the stage of insulin resistance. MATERIALS AND METHODS: The average, minimum and sectoral (inferior, superior, inferonasal, superonasal, inferotemporal and superotemporal) thicknesses of the ganglion cell-inner plexiform layer (GCIPL) measured using optical coherence tomography were compared between an insulin-resistant group and control group in order to evaluate the presence of retinal neurodegeneration. The CS of the two groups was also compared according to the logarithmic values measured at spatial frequencies of 1.5, 3, 6, 12 and 18 cycles per degree in photopic light using functional acuity contrast test (FACT). RESULTS: Twenty-five eyes of 25 patients with insulin resistance (insulin resistant group) and 25 eyes of 25 healthy subjects (control group) were included in this study. There were no statistically significant differences between the two groups in any of the spatial frequencies in the FACT. The mean average GCIPL thickness and mean GCIPL thickness in the inferotemporal sector were significantly less in the insulin-resistant group when compared with the control group (mean average GCIPL thicknesses in the insulin-resistant and control groups were 83.6±4.7 µm and 86.7±3.7 µm respectively, p=0.01; mean inferotemporal GCIPL thicknesses in the insulin-resistant and control groups were 83±6.0 µm and 86.7±4.6 µm respectively, p=0.02). CONCLUSION: Although it may not lead to functional visual impairment such as CS loss, the retinal neurodegeneration seen in diabetic patients may begin in the insulin resistance stage.