| Title: | Detecting retinal neurodegeneration in people with diabetes: Findings from the UK Biobank |
| Journal: | PLOS ONE |
| Published: | 29 Sep 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/34587216/ |
| DOI: | https://doi.org/10.1371/journal.pone.0257836 |
| URL: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0257836&type=printable |
Publication 4656
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Abstract
IMPORTANCE: Efforts are underway to incorporate retinal neurodegeneration in the diabetic retinopathy severity scale. However, there is no established measure to quantify diabetic retinal neurodegeneration (DRN).</p>
OBJECTIVE: We compared total retinal, macular retinal nerve fiber layer (mRNFL) and ganglion cell-inner plexiform layer (GC-IPL) thickness among participants with and without diabetes (DM) in a population-based cohort.</p>
DESIGN/SETTING/PARTICIPANTS: Cross-sectional analysis, using the UK Biobank data resource. Separate general linear mixed models (GLMM) were created using DM and glycated hemoglobin as predictor variables for retinal thickness. Sub-analyses included comparing thickness measurements for patients with no/mild diabetic retinopathy (DR) and evaluating factors associated with retinal thickness in participants with and without diabetes. Factors found to be significantly associated with DM or thickness were included in a multiple GLMM.</p>
EXPOSURE: Diagnosis of DM was determined via self-report of diagnosis, medication use, DM-related complications or glycated hemoglobin level of ≥ 6.5%.</p>
MAIN OUTCOMES AND MEASURES: Total retinal, mRNFL and GC-IPL thickness.</p>
RESULTS: 74,422 participants (69,985 with no DM; 4,437 with DM) were included. Median age was 59 years, 46% were men and 92% were white. Participants with DM had lower total retinal thickness (-4.57 μm, 95% CI: -5.00, -4.14; p<0.001), GC-IPL thickness (-1.73 μm, 95% CI: -1.86, -1.59; p<0.001) and mRNFL thickness (-0.68 μm, 95% CI: -0.81, -0.54; p<0.001) compared to those without DM. After adjusting for co-variates, in the GLMM, total retinal thickness was 1.99 um lower (95% CI: -2.47, -1.50; p<0.001) and GC-IPL was 1.02 μm lower (95% CI: -1.18, -0.87; p<0.001) among those with DM compared to without. mRNFL was no longer significantly different (p = 0.369). GC-IPL remained significantly lower, after adjusting for co-variates, among those with DM compared to those without DM when including only participants with no/mild DR (-0.80 μm, 95% CI: -0.98, -0.62; p<0.001). Total retinal thickness decreased 0.40 μm (95% CI: -0.61, -0.20; p<0.001), mRNFL thickness increased 0.20 μm (95% CI: 0.14, 0.27; p<0.001) and GC-IPL decreased 0.26 μm (95% CI: -0.33, -0.20; p<0.001) per unit increase in A1c after adjusting for co-variates. Among participants with diabetes, age, DR grade, ethnicity, body mass index, glaucoma, spherical equivalent, and visual acuity were significantly associated with GC-IPL thickness.</p>
CONCLUSION: GC-IPL was thinner among participants with DM, compared to without DM. This difference persisted after adjusting for confounding variables and when considering only those with no/mild DR. This confirms that GC-IPL thinning occurs early in DM and can serve as a useful marker of DRN.</p>
17 Keywords
- Adult
- Aged
- Biological Specimen Banks
- Cross-Sectional Studies
- Diabetes Mellitus
- Diabetic Retinopathy
- Female
- Glycated Hemoglobin
- Humans
- Male
- Middle Aged
- Nerve Fibers
- Retina
- Self Report
- Severity of Illness Index
- Tomography, Optical Coherence
- United Kingdom
14 Authors
- Roomasa Channa
- Kyungmoo Lee
- Kristen A. Staggers
- Nitish Mehta
- Sidra Zafar
- Jie Gao
- Benjamin J. Frankfort
- Sharon Y. L. Chua
- Anthony P. Khawaja
- Paul J. Foster
- Praveen J. Patel
- Charles G. Minard
- Chris Amos
- Michael D. Abramoff
1 Application
| Application ID | Title |
|---|---|
| 41561 | Genetic factors associated with Diabetic retinopathy |
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