Journal article
Relationship of OCT-Based Diabetic Retinal Neurodegeneration to the Development and Progression of Diabetic Retinopathy: A Cohort Study
Investigative ophthalmology & visual science, Vol.66(2), 32
02/11/2025
DOI: 10.1167/iovs.66.2.32
PMCID: PMC11817850
PMID: 39932471
Abstract
To evaluate the relationship between diabetic retinal neurodegeneration (DRN), as quantified by optical coherence tomography (OCT), to the development of diabetic retinopathy (DR), progression of DR, and development of proliferative DR (PDR).
This was a prospective cohort study, including 385 eyes with no DR or nonproliferative DR at baseline. The thicknesses of the macular ganglion cell-inner plexiform layer (m-GCIPL), macular retinal nerve fiber layer, and peripapillary RNFL (p-RNFL) were measured using Cirrus OCT (Carl Zeiss Meditec, Dublin, CA, USA). DR outcomes were determined from macula- and optic disc-centered fundus photographs, following the modified Airlie House classification system. Cox proportional hazards models were used to estimate hazard ratio (HR) adjusting for age, mean arterial blood pressure, diabetes mellitus duration, HbA1c, diabetic kidney disease, axial length, OCT signal strength, and disc area (for p-RNFL only).
After a median follow-up of 6.2 years (range 5.0-7.7 years), 79 eyes developed DR, 99 eyes developed DR progression, and 38 eyes developed PDR. Thinner mean and sectorial m-GCIPL thicknesses were significantly associated with higher risk of DR development, with HRs ≥ 1.373 (1.023-1.843), except for the superonasal and superotemporal sectors. Similar to DR development, thinner m-GCIPL thicknesses were significantly associated with DR progression and PDR development, with HRs ranging from 1.306 (1.094-1.559) to 2.331 (1.524-3.566). Additionally, the inclusion of inferior m-GCIPL thickness significantly improved the predictive discrimination for DR development (C statistics: 0.661 vs. 0.705, P < 0.001), and DR progression (C statistics: 0.704 vs. 0.729, P < 0.001), as well as inferotemporal m-GCIPL for PDR development (C statistic: 0.917 vs. 0.930, P < 0.001) beyond established risk factors.
OCT measurements that elucidate DRN may enhance prognostic identification and predictive discrimination of DR development, DR progression, and PDR development beyond established risk factors.
Details
- Title: Subtitle
- Relationship of OCT-Based Diabetic Retinal Neurodegeneration to the Development and Progression of Diabetic Retinopathy: A Cohort Study
- Creators
- Ziqi Tang - Chinese University of Hong KongDawei Yang - Chinese University of Hong KongTruong X Nguyen - Chinese University of Hong KongShuyi Zhang - Chinese University of Hong KongDanqi Fang - Chinese University of Hong KongVictor T T Chan - Chinese University of Hong KongClement C Tham - Hong Kong Eye HospitalElliott H Sohn - University of IowaKen K Tsang - Chinese University of Hong KongCherie Y K Wong - Chinese University of Hong KongVivian W K Hui - Chinese University of Hong KongAmy H Y Yu - Hong Kong Eye HospitalJulia T W Lam - Chinese University of Hong KongCarmen K M Chan - Chinese University of Hong KongTimothy Y Y Lai - Chinese University of Hong KongSimon K H Szeto - Hong Kong Eye HospitalCarol Y Cheung - Chinese University of Hong Kong
- Resource Type
- Journal article
- Publication Details
- Investigative ophthalmology & visual science, Vol.66(2), 32
- DOI
- 10.1167/iovs.66.2.32
- PMID
- 39932471
- PMCID
- PMC11817850
- NLM abbreviation
- Invest Ophthalmol Vis Sci
- ISSN
- 1552-5783
- eISSN
- 1552-5783
- Publisher
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC
- Grant note
- CUHK Direct Grant: 4054419, 054419
Supported by CUHK Direct Grant (Project Code: 4054419 & 4054487)
- Language
- English
- Date published
- 02/11/2025
- Academic Unit
- Fraternal Order of Eagles Diabetes Research Center; Ophthalmology and Visual Sciences
- Record Identifier
- 9984787443602771
Metrics
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