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Research article
Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose
Xiaobing Yu
Beijing Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3318-1720
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aim: To investigate the changes of retinal optic disc nerve fiber layer thickness and macular blood flow density in preclinical stage of diabetic retinopathy and their relationship with blood glucose.
Methods: In this cross-sectional study,97 diabetic patients(total 188 eyes,144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group ) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different group by HbA1c , and underwent ocular examination by optical coherence tomography angiography. We compare optical coherence tomography angiography parameter and retinal nerve fiber layer thickness among different glucose group.
Results: The parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (P < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index as compared with the normal group. From the normal group to no diabetic retinopathy group and then to mild non-proliferative retinopathy group, vessel density decreased and acircularity index increased (P < 0.001). Foveal vascular density and parafoveal vessel density decreased with the increase of HbA1c. There was a negative correlation between parafoveal vessel density of the deep retinal vascular layer and FBG (P<0.01). The temporal retinal nerve fiber layer thickness decreased among different HbA1c levels groups and was positively correlated with the parafoveal vessel density in superficial retinal vascular layer(P<0.05).
Conclusions: This study shows retinal microvasculopathy and neuropathy has been present during no retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal RNFL thickness was positively correlated with the vessel density of superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists to detect early diabetic retinal pathological lesions.
Keywords
vessel density, acircularity index, retinal nerve fiber layer thickness, retinopathy, type 2 diabetes
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CURRENT STATUS: Under Review
Version 1
Posted 18 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 05 Dec, 2020
Review #2 received
Received 18 Nov, 2020
Review #3 received
Received 10 Nov, 2020
Reviewer #4 agreed
On 06 Nov, 2020
Reviewer #3 agreed
On 06 Nov, 2020
Reviewer #2 agreed
On 01 Nov, 2020
Review #1 received
Received 14 Oct, 2020
Reviewers invited
Invitations sent on 22 Sep, 2020
Reviewer #1 agreed
On 22 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor assigned
On 16 Sep, 2020
Editor invited
On 15 Sep, 2020
First submitted
On 12 Sep, 2020
Metrics
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Subject Areas
Ophthalmology
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This preprint is under consideration at BMC Ophthalmology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Early Neurovascular Changes in the Retina in Preclinical Diabetic Retinopathy and Relation to Blood Glucose
Xiaobing Yu
Beijing Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3318-1720
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 Sep, 2020
No community comments so far
Editorial decision: Major revision
On 05 Dec, 2020
Review #2 received
Received 18 Nov, 2020
Review #3 received
Received 10 Nov, 2020
Reviewer #4 agreed
On 06 Nov, 2020
Reviewer #3 agreed
On 06 Nov, 2020
Reviewer #2 agreed
On 01 Nov, 2020
Review #1 received
Received 14 Oct, 2020
Reviewers invited
Invitations sent on 22 Sep, 2020
Reviewer #1 agreed
On 22 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor assigned
On 16 Sep, 2020
Editor invited
On 15 Sep, 2020
First submitted
On 12 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Aim: To investigate the changes of retinal optic disc nerve fiber layer thickness and macular blood flow density in preclinical stage of diabetic retinopathy and their relationship with blood glucose.
Methods: In this cross-sectional study,97 diabetic patients(total 188 eyes,144 eyes in no diabetic retinopathy group, 44 eyes in mild diabetic non-proliferative retinopathy group ) and 35 healthy people (70 eyes) were enrolled, All the subjects were divided into different group by HbA1c , and underwent ocular examination by optical coherence tomography angiography. We compare optical coherence tomography angiography parameter and retinal nerve fiber layer thickness among different glucose group.
Results: The parafoveal vessel density and the temporal retinal nerve fiber layer thickness were lower (P < 0.05) in the diabetic group than in the normal group. The diabetic group showed a higher acircularity index as compared with the normal group. From the normal group to no diabetic retinopathy group and then to mild non-proliferative retinopathy group, vessel density decreased and acircularity index increased (P < 0.001). Foveal vascular density and parafoveal vessel density decreased with the increase of HbA1c. There was a negative correlation between parafoveal vessel density of the deep retinal vascular layer and FBG (P<0.01). The temporal retinal nerve fiber layer thickness decreased among different HbA1c levels groups and was positively correlated with the parafoveal vessel density in superficial retinal vascular layer(P<0.05).
Conclusions: This study shows retinal microvasculopathy and neuropathy has been present during no retinopathy. The vessel density of the deep retinal vascular layer was negatively correlated with fasting blood glucose, and the temporal RNFL thickness was positively correlated with the vessel density of superficial retinal vascular layer. These indicators are helpful for endocrinologists and ophthalmologists to detect early diabetic retinal pathological lesions.
Figure 1