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

Katherine A Joltikov; Vinicius M de Castro; Jose R Davila; Rohit Anand; Sami M Khan; Neil Farbman; Gregory R Jackson; Chris A Johnson; Thomas W Gardner

doi:10.1167/iovs.17-21863

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

Journal article

Open access

Peer reviewed

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

Katherine A Joltikov, Vinicius M de Castro, Jose R Davila, Rohit Anand, Sami M Khan, Neil Farbman, Gregory R Jackson, Chris A Johnson and Thomas W Gardner

Investigative ophthalmology & visual science, Vol.58(6), pp.BIO277-BIO290

05/01/2017

DOI: 10.1167/iovs.17-21863

PMCID: PMC5624741

PMID: 28973314

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Abstract

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. 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). 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. This multimodal testing analysis reveals insights into disruption of the neuroretina in diabetes and may accelerate the testing of novel therapies.

Visual Field Tests - methods

Visual Fields - physiology

Contrast Sensitivity - physiology

Sensory Thresholds

Tomography, Optical Coherence

Humans

Middle Aged

Retina - physiopathology

Male

Diabetic Retinopathy - pathology

Case-Control Studies

Diabetic Retinopathy - physiopathology

Young Adult

Analysis of Variance

Adult

Female

Visual Acuity - physiology

Details

Title: Subtitle: Multidimensional Functional and Structural Evaluation Reveals Neuroretinal Impairment in Early Diabetic Retinopathy
Creators: Katherine A Joltikov - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Vinicius M de Castro - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Jose R Davila - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Rohit Anand - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Sami M Khan - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Neil Farbman - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Gregory R Jackson - MacuLogix, Inc., Hummelstown, Pennsylvania, United States
Chris A Johnson - Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa, United States
Thomas W Gardner - Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
Resource Type: Journal article
Publication Details: Investigative ophthalmology & visual science, Vol.58(6), pp.BIO277-BIO290
DOI: 10.1167/iovs.17-21863
PMID: 28973314
PMCID: PMC5624741
NLM abbreviation: Invest Ophthalmol Vis Sci
ISSN: 0146-0404
eISSN: 1552-5783
Grant note: P30 DK020572 / NIDDK NIH HHS R24 DK082841 / NIDDK NIH HHS
Language: English
Date published: 05/01/2017
Academic Unit: Ophthalmology and Visual Sciences
Record Identifier: 9984101603102771

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