Aragon Institute for Health Research (IIS Aragon), Zaragoza, Spain.
Department of Ophthalmology, Lozano Blesa University Hospital, Zaragoza, Spain.
Retina. 2020 Jul;40(7):1379-1386. doi: 10.1097/IAE.0000000000002576.
To evaluate changes in retinal layer thickness in patients with Type 1 diabetes with no diabetic retinopathy after 8 years of follow-up.
Ninety Type 1 diabetes and 60 control eyes were studied. Changes in the retinal nerve fiber layer, ganglion cell layer, and inner nuclear layer thicknesses in all Early Treatment Diabetic Retinopathy Study areas were evaluated.
The mean ages were 42.93 ± 13.62 and 41.52 ± 13.05 years in the diabetic and control group, respectively. In 2009, total retinal thickness was higher in diabetic patients; differences were statistically significant in all except the nasal areas. In both groups, the mean foveal thickness remained the same during the 8 years. Among diabetic patients, there was a significant reduction in total retinal thickness in all areas excluding the outer temporal one; controls only in the inferior areas. The thickness loss was due to the thinning of the inner retinal layers (inner nuclear layer, ganglion cell layer, and retinal nerve fiber layer). The controls showed a significant diminution in the retinal nerve fiber layer and in the ganglion cell layer areas. The inner nuclear layer showed a diminution in the diabetes mellitus group.
Before the onset of diabetic retinopathy, Type 1 diabetes patients experience a diminution of their inner retinal layer thicknesses over time, supporting the hypothesis of retinal neurodegeneration.
评估无糖尿病视网膜病变的 1 型糖尿病患者在 8 年随访后的视网膜层厚度变化。
研究了 90 例 1 型糖尿病患者和 60 例对照眼。评估了所有早期糖尿病性视网膜病变研究区域的视网膜神经纤维层、节细胞层和内核层厚度的变化。
糖尿病组和对照组的平均年龄分别为 42.93 ± 13.62 岁和 41.52 ± 13.05 岁。2009 年，糖尿病患者的总视网膜厚度较高；除鼻侧区域外，差异均有统计学意义。在两组中，8 年内平均黄斑中心凹厚度保持不变。在糖尿病患者中，除外颞侧外，所有区域的总视网膜厚度均显著减少；对照组仅在下侧区域减少。厚度损失是由于内视网膜层（内核层、节细胞层和视网膜神经纤维层）变薄所致。对照组的视网膜神经纤维层和节细胞层区域明显变薄。糖尿病组的内核层也有所减少。
在糖尿病性视网膜病变发生之前，1 型糖尿病患者的内视网膜层厚度随时间逐渐减少，支持视网膜神经退行性变的假说。
