Retinal Nerve Fiber Layer Defect In Patients With Type â…¡ Diabetes Mellitus

ObjectiveTo investigate the defect of retinal nerve fiber layer in Patients with typeⅡdiabetes mellitus.Methods41 patients (81 eyes) with typeⅡdiabetes mellitus were enrolled. The patients consisted of 21 men and 20 women, ranging in age from 49～72 years, mean 54.2 years. The diabetic history and treatment were recorded. The fasting blood glucose, postprandial blood sugar and glycosylated hemoglobin (HbAlc) were detected. All the patients underwent detailed ophthalmological examination, including the visual acuity, IOP, anterior segment, fundus examination with papillary dilation, fundus fluorescein angiography (FFA). The patients with typeⅡdiabetes mellitus were divided into 4 groups by criterion of FFA, including patients without diabetic retinopathy (NDR group), patients with background diabetic retinopathy (BDR group), patients with proliferative diabetic retinopathy (PDR group) and patients underwent PRP (PRP group). 20 age-matched normal subjects were enrolled as control group. The RNFL thickness was measured by GDxVCC. The data of the RNFL thickness were analysised by one-factor analysis of variance, Student Newman Keuls test (SNK).ResultsThe TSNIT average, superior average, inferior average, TSNIT standard deviation of the PDR group decreased. The statistical differences in TSNIT average, superior average, inferior average, TSNIT standard deviation were found between the PDR group and the control group. The TSNIT average, superior average, inferior average, TSNIT standard deviation of the PRP group decreased. The nerve fiber indication of the PRP group increased. The statistical differences in all the RNFL parameters were found between the PRP group and the control group. The TSNIT average, superior average, inferior average, TSNIT standard deviation of the NDR group and BDR group decreased. The nerve fiber indication of the NDR group and BDR group increased. Compared with the control group, no statistical differences was found between the groups.ConclusionGDxVCC can be used to detect the change of RNFL induced by typeⅡdiabetes mellitus. The decrease of the RNFL thickness can occur in the patients without retinopathy. The RNFL thickness of the patients with PDR and the patients underwent PRP decrease, suggesting the degeneration of neurons and axonal atrophy. The ophthalmologist should choose the proper parameter during the process of PRP, avoid excessive photocoagulation, decrease the defect of RNFL induced by PRP. The neurodegeneration is a important component of diabetic retinopathy. Neuroprotection play a important role in the prevention and treatment of diabetic retinopathy.