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Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy

PURPOSE: To test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease. METHODS: Fifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild...

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Autores principales: Joltikov, Katherine A., de Castro, Vinicius M., Davila, Jose R., Anand, Rohit, Khan, Sami M., Farbman, Neil, Jackson, Gregory R., Johnson, Chris A., Gardner, Thomas W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Association for Research in Vision and Ophthalmology 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624741/
https://www.ncbi.nlm.nih.gov/pubmed/28973314
http://dx.doi.org/10.1167/iovs.17-21863
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author Joltikov, Katherine A.
de Castro, Vinicius M.
Davila, Jose R.
Anand, Rohit
Khan, Sami M.
Farbman, Neil
Jackson, Gregory R.
Johnson, Chris A.
Gardner, Thomas W.
author_facet Joltikov, Katherine A.
de Castro, Vinicius M.
Davila, Jose R.
Anand, Rohit
Khan, Sami M.
Farbman, Neil
Jackson, Gregory R.
Johnson, Chris A.
Gardner, Thomas W.
author_sort Joltikov, Katherine A.
collection PubMed
description PURPOSE: To test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease. METHODS: Fifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild nonproliferative diabetic retinopathy [mild NPDR], 15 with moderate to severe [moderate NPDR]), and 18 controls underwent full ophthalmic examination, fundus photography, spectral-domain optical coherence tomography (SD-OCT), e-ETDRS (Early Treatment Diabetic Retinopathy Study) acuity, and the quick contrast sensitivity function (qCSF) method. Perimetry testing included short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), frequency doubling perimetry (FDP), and rarebit perimetry (RBP). RESULTS: ETDRS acuity and RBP were not sensitive for functional differences among subjects with diabetes. AULCSF, a metric of qCSF, was reduced in diabetics with moderate compared to mild NPDR (P = 0.03), and in subjects with no DR compared to controls (P = 0.04). SWAP and SAP mean deviation (MD) and foveal threshold (FT) were reduced in moderate compared to mild NPDR (SWAP, MD P = 0.002, FT P = 0.0006; SAP, MD P = 0.02, FT P = 0.007). FDP 10-2 showed reduced MD in moderate compared to mild NPDR (P = 0.02), and FDP 24-2 revealed reduced pattern standard deviation (PSD) in mild NPDR compared to no DR (P = 0.02). Structural analysis revealed thinning of the ganglion cell layer and inner plexiform layer (GCL+IPL) of moderate NPDR subjects compared to controls. The thinner GCL+IPL correlated with impaired retinal function. CONCLUSIONS: This multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies.
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spelling pubmed-56247412017-10-03 Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy Joltikov, Katherine A. de Castro, Vinicius M. Davila, Jose R. Anand, Rohit Khan, Sami M. Farbman, Neil Jackson, Gregory R. Johnson, Chris A. Gardner, Thomas W. Invest Ophthalmol Vis Sci Special Issue PURPOSE: To test whether quantitative functional tests and optical coherence tomography (OCT)-defined structure can serve as effective tools to diagnose and monitor early diabetic neuroretinal disease. METHODS: Fifty-seven subjects with diabetes (23 without diabetic retinopathy [no DR], 19 with mild nonproliferative diabetic retinopathy [mild NPDR], 15 with moderate to severe [moderate NPDR]), and 18 controls underwent full ophthalmic examination, fundus photography, spectral-domain optical coherence tomography (SD-OCT), e-ETDRS (Early Treatment Diabetic Retinopathy Study) acuity, and the quick contrast sensitivity function (qCSF) method. Perimetry testing included short-wavelength automated perimetry (SWAP), standard automated perimetry (SAP), frequency doubling perimetry (FDP), and rarebit perimetry (RBP). RESULTS: ETDRS acuity and RBP were not sensitive for functional differences among subjects with diabetes. AULCSF, a metric of qCSF, was reduced in diabetics with moderate compared to mild NPDR (P = 0.03), and in subjects with no DR compared to controls (P = 0.04). SWAP and SAP mean deviation (MD) and foveal threshold (FT) were reduced in moderate compared to mild NPDR (SWAP, MD P = 0.002, FT P = 0.0006; SAP, MD P = 0.02, FT P = 0.007). FDP 10-2 showed reduced MD in moderate compared to mild NPDR (P = 0.02), and FDP 24-2 revealed reduced pattern standard deviation (PSD) in mild NPDR compared to no DR (P = 0.02). Structural analysis revealed thinning of the ganglion cell layer and inner plexiform layer (GCL+IPL) of moderate NPDR subjects compared to controls. The thinner GCL+IPL correlated with impaired retinal function. CONCLUSIONS: This multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies. The Association for Research in Vision and Ophthalmology 2017-10 /pmc/articles/PMC5624741/ /pubmed/28973314 http://dx.doi.org/10.1167/iovs.17-21863 Text en Copyright 2017 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Special Issue
Joltikov, Katherine A.
de Castro, Vinicius M.
Davila, Jose R.
Anand, Rohit
Khan, Sami M.
Farbman, Neil
Jackson, Gregory R.
Johnson, Chris A.
Gardner, Thomas W.
Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
title Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
title_full Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
title_fullStr Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
title_full_unstemmed Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
title_short Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
title_sort multidimensional functional and structural evaluation reveals neuroretinal impairment in early diabetic retinopathy
topic Special Issue
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624741/
https://www.ncbi.nlm.nih.gov/pubmed/28973314
http://dx.doi.org/10.1167/iovs.17-21863
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