Analysis Of Retinal Nerve Fiber Layer Thickness In Type2Diabetic Patients With Normal Fundus

Object: Analysis the difference of retinal nerve fiber layer (RNFL)thickness in normal fundus between type2diabetic patients and normalsubjects. Explore the relevant risk factors between RNFL thickness and theduration of diabetes mellitus， blood glucose, glycosylated hemoglobin,microalbuminuria, fasting C peptide in diabetic patients.Methods: Thirty type2diabetic patients with normal fundus treated in theendocrinology department of our hospital from January2011to February2012with30cases were diabetic group with age25-73，mean age52.67±10.11.Sixty two eyes from31normal subjects with age30-68mean age51.16±8.90were as controls. Visual acuity, intraocular pressure, fundus examination,optical coherence tomography(OCT) detection of RNFL thickness weremeasured in both groups. Systemic factors including fasting plasma glucose,Postprandial2hour glucose, glycosylated hemoglobin, microalbuminuria，fasting C peptide were detected in diabetic group. The results were analysis bySPSS16.0statistical package. T test was used in the comparison of RNFLthickness in two groups. Spearsman inspection was used in the correlationanalysis of RNFL thickness and age in diabetic group. Pearson correlation testwas used in the correlation analysis of RNFL thickness and systemic factors. P<0.05was considered statistically significant.Results:1. The average RNFL thickness(G), superior RNFL thickness(S)were thinner in diabetic group(p <0.05). the superior and inferior quadrant werefurther divided. Nasal-superior RNFL thickness (NS) were thinner in diabeticgroup(p <0.05). No statistically significant difference was found in temporal,inferior，nasal RNFL thickness in two groups(p>0.05).2. The temporal quadrant RNFL thickness (T) in diabetic group was negatively correlated withage(p <0.05). The average RNFL thickness (G), superior RNFL thickness(S)were negatively correlated with age in control group.3. There was a negativecorrelation between postprandial2hour glucose and superior RNFL thickness(S). There were negative correlation between glycated hemoglobin and superiorRNFL thickness (S), average RNFL thickness (G) respectively. Fasting bloodglucose, duration of diabetes mellitus, microalbuminuria and fasting C peptidehad no correlation with RNFL thickness (P>0.05).Conclusions：1. Diabetic patients with normal fundus appeare thinningof RNFL thickness, which is a early sign of neuronal retinopathy. OCT can beused to detect whether there is neuronal retinopathy in diabetic patients withnormal fundus.2. There is significant correlation between age and RNFLthickness in diabetes patients and normal controls.3. There are negativecorrelation between postprandial2hour glucose, glycosylated hemoglobin andRNFL thickness respectively. Fasting blood glucose, duration of diabetesmellitus, microalbuminuria and fasting C peptide had no correlation with RNFLthickness.