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Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes
PURPOSE: To evaluate the relationship of neuroretinal layer thickness with sensitive measures of cardiovascular autonomic neuropathy in diabetic patients with non‐proliferative diabetic retinopathy (NPDR). METHODS: Twenty‐seven eyes of 27 patients with type 1 diabetes presenting with mild‐to‐moderat...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282971/ https://www.ncbi.nlm.nih.gov/pubmed/29504257 http://dx.doi.org/10.1111/aos.13733 |
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author | Pemp, Berthold Palkovits, Stefan Howorka, Kinga Pumprla, Jiri Sacu, Stefan Garhöfer, Gerhard Bayerle‐Eder, Michaela Schmetterer, Leopold Schmidt‐Erfurth, Ursula |
author_facet | Pemp, Berthold Palkovits, Stefan Howorka, Kinga Pumprla, Jiri Sacu, Stefan Garhöfer, Gerhard Bayerle‐Eder, Michaela Schmetterer, Leopold Schmidt‐Erfurth, Ursula |
author_sort | Pemp, Berthold |
collection | PubMed |
description | PURPOSE: To evaluate the relationship of neuroretinal layer thickness with sensitive measures of cardiovascular autonomic neuropathy in diabetic patients with non‐proliferative diabetic retinopathy (NPDR). METHODS: Twenty‐seven eyes of 27 patients with type 1 diabetes presenting with mild‐to‐moderate NPDR were compared to 27 healthy control (HC) eyes matched for age and gender. The total macular volume (TMV) and the volumes of individual neurosensory layers in the macula were analysed from spectral domain optical coherence tomography using automated layer segmentation. Cardiovascular autonomic regulation was assessed by short‐term power spectrum analysis of heart rate variability (HRV) before, during and after an orthostatic challenge. RESULTS: The patients had an age of 46 ± 12 years and diabetes since 28 ± 9 years. Diastolic and mean arterial pressure was lower in the patients compared to HCs. TMV (r = 0.58, p = 0.002), inner plexiform layer volume (IPLV; r = 0.39, p = 0.047) and inner nuclear layer volume (INLV; r = 0.60, p = 0.001) were associated with reduced recovery of low‐frequency (LF) spectral power of HRV after orthostatic load in diabetic patients but not in HCs. The response of LF spectral power during the orthostatic manoeuvre was blunted in patients compared to HCs (p = 0.02). Diabetes duration was negatively associated with TMV and INLV, whereas IPLV was significantly reduced in eyes with moderate NPDR compared to HCs. CONCLUSION: The results indicate a correlation between inner retinal tissue loss and diminished autonomic regulation in type 1 diabetic patients with mild‐to‐moderate NPDR. The observed changes can be interpreted as congruent early signs of retinal and systemic neuropathy in diabetes. |
format | Online Article Text |
id | pubmed-6282971 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-62829712018-12-14 Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes Pemp, Berthold Palkovits, Stefan Howorka, Kinga Pumprla, Jiri Sacu, Stefan Garhöfer, Gerhard Bayerle‐Eder, Michaela Schmetterer, Leopold Schmidt‐Erfurth, Ursula Acta Ophthalmol Original Articles PURPOSE: To evaluate the relationship of neuroretinal layer thickness with sensitive measures of cardiovascular autonomic neuropathy in diabetic patients with non‐proliferative diabetic retinopathy (NPDR). METHODS: Twenty‐seven eyes of 27 patients with type 1 diabetes presenting with mild‐to‐moderate NPDR were compared to 27 healthy control (HC) eyes matched for age and gender. The total macular volume (TMV) and the volumes of individual neurosensory layers in the macula were analysed from spectral domain optical coherence tomography using automated layer segmentation. Cardiovascular autonomic regulation was assessed by short‐term power spectrum analysis of heart rate variability (HRV) before, during and after an orthostatic challenge. RESULTS: The patients had an age of 46 ± 12 years and diabetes since 28 ± 9 years. Diastolic and mean arterial pressure was lower in the patients compared to HCs. TMV (r = 0.58, p = 0.002), inner plexiform layer volume (IPLV; r = 0.39, p = 0.047) and inner nuclear layer volume (INLV; r = 0.60, p = 0.001) were associated with reduced recovery of low‐frequency (LF) spectral power of HRV after orthostatic load in diabetic patients but not in HCs. The response of LF spectral power during the orthostatic manoeuvre was blunted in patients compared to HCs (p = 0.02). Diabetes duration was negatively associated with TMV and INLV, whereas IPLV was significantly reduced in eyes with moderate NPDR compared to HCs. CONCLUSION: The results indicate a correlation between inner retinal tissue loss and diminished autonomic regulation in type 1 diabetic patients with mild‐to‐moderate NPDR. The observed changes can be interpreted as congruent early signs of retinal and systemic neuropathy in diabetes. John Wiley and Sons Inc. 2018-03-05 2018-11 /pmc/articles/PMC6282971/ /pubmed/29504257 http://dx.doi.org/10.1111/aos.13733 Text en © 2018 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Pemp, Berthold Palkovits, Stefan Howorka, Kinga Pumprla, Jiri Sacu, Stefan Garhöfer, Gerhard Bayerle‐Eder, Michaela Schmetterer, Leopold Schmidt‐Erfurth, Ursula Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
title | Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
title_full | Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
title_fullStr | Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
title_full_unstemmed | Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
title_short | Correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
title_sort | correlation of retinal neurodegeneration with measures of peripheral autonomic neuropathy in type 1 diabetes |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282971/ https://www.ncbi.nlm.nih.gov/pubmed/29504257 http://dx.doi.org/10.1111/aos.13733 |
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