Abstract
Objectives
To comprehensively assess diabetic retinopathy neurodegeneration (DRN) as quantified by retinal neuronal and axonal layers measured with spectral-___domain optical coherence tomography (SD-OCT) in subjects with diabetes mellitus (DM).
Methods
Articles on the topic of examining macular ganglion cell-inner plexiform layer (m-GCIPL), macular retinal nerve fibre layer (m-RNFL), macular ganglion cell complex (m-GCC), and peripapillary RNFL (p-RNFL) measured with SD-OCT in DM subjects without DR (NDR) or with non-proliferative DR (NPDR) were searched in PubMed and Embase up to November 31, 2019. Standardized mean difference (SMD) as effect size were pooled using random-effects model.
Results
Thirty-six studies searched from online databases and the CUHK DM cohort were included in the meta-analysis. In the comparison between NDR and control, macular measures including mean m-GCIPL (SMD = −0.26, p = 0.003), m-RNFL (SMD = −0.26, p = 0.046), and m-GCC (SMD = −0.28; p = 0.009) were significantly thinner in the NDR group. In the comparison between NPDR and NDR, only mean p-RNFL was significantly thinner in the NPDR group (SMD = −0.27; p = 0.03), but not other macular measures.
Conclusions
Thinning of retinal neuronal and axonal layers at macula as measured by SD-OCT are presented in eyes with NDR, supporting DRN may be the early pathogenesis in the DM patients without the presence of clinical signs of DR. In the future, these SD-OCT measures may be used as surrogates of DRN to stratify DM patients with a high risk of DR, and may be used as a therapeutic target if neuroprotection treatment for DR is available.
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eTable 4. Meta-regression analysis to examine the effect of age, type of DM, HbA1c and duration of DM on the Standardized Mean Difference in the group comparisons.
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Tang, Z., Chan, M.Y., Leung, W.Y. et al. Assessment of retinal neurodegeneration with spectral-___domain optical coherence tomography: a systematic review and meta-analysis. Eye 35, 1317–1325 (2021). https://doi.org/10.1038/s41433-020-1020-z
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DOI: https://doi.org/10.1038/s41433-020-1020-z
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