Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy
Purpose: Neurovascular coupling impairment and inner retinal layer thinning are early detectable retinal changes in diabetes, and both worsen during progression of diabetic retinopathy (DR). However, direct interactions between these features have not been investigated so far. Therefore, we aimed to...
| Үндсэн зохиолчид: | , , , , , , |
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| Бусад зохиолчид: | |
| Формат: | Journal Article |
| Хэл сонгох: | English |
| Хэвлэсэн: |
2024
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| Нөхцлүүд: | |
| Онлайн хандалт: | https://hdl.handle.net/10356/180100 |
| _version_ | 1826114750644224000 |
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| author | Pemp, Berthold Palkovits, Stefan Sacu, Stefan Schmidl, Doreen Garhöfer, Gerhard Schmetterer, Leopold Schmidt-Erfurth, Ursula |
| author2 | School of Chemical and Biomedical Engineering |
| author_facet | School of Chemical and Biomedical Engineering Pemp, Berthold Palkovits, Stefan Sacu, Stefan Schmidl, Doreen Garhöfer, Gerhard Schmetterer, Leopold Schmidt-Erfurth, Ursula |
| author_sort | Pemp, Berthold |
| collection | NTU |
| description | Purpose: Neurovascular coupling impairment and inner retinal layer thinning are early detectable retinal changes in diabetes, and both worsen during progression of diabetic retinopathy (DR). However, direct interactions between these features have not been investigated so far. Therefore, we aimed to analyze associations between the retinal functional hyperemic response to light stimulation and the thickness of individual neuroretinal layers in eyes with early non-proliferative DR. Methods: Thirty patients with type 1 diabetes featuring mild (n = 15) or moderate (n = 15) non-proliferative DR and 14 healthy subjects were included in this cross-sectional study. Retinal vessel diameters were measured before and during illumination with flickering light using a dynamic vessel analyzer. Individual layer thickness in the macula was analyzed from spectral domain optical coherence tomography. Results: Flicker light-induced vessel dilation was significantly reduced in patients compared to healthy controls (veins: 3.0% vs. 6.1%, p < 0.001; arteries: 1.3% vs. 5.1%, p = 0.005). Univariately, the response in retinal veins of diabetes patients correlated significantly with ganglion cell layer (GCL) thickness (r = 0.46, p = 0.010), and negatively with hemoglobin A1c (HbA1c) levels (r=-0.41, p = 0.023) and age (r=-0.38, p = 0.037), but not with baseline diameters, glucose levels, or diabetes duration. In a multiple regression model only GCL thickness (p = 0.017, β = 0.42) and HbA1c (p = 0.045, β=-0.35) remained significantly associated with the vascular flicker light response. Conclusion: The results indicate that thinner GCL and worse glycemic control both contribute to reduced retinal neurovascular coupling in patients with clinical signs of DR. Progression of neurovascular dysfunction in DR might be related to structural degeneration of the neurovascular complex in the inner retina. |
| first_indexed | 2024-10-01T03:44:15Z |
| format | Journal Article |
| id | ntu-10356/180100 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2024-10-01T03:44:15Z |
| publishDate | 2024 |
| record_format | dspace |
| spelling | ntu-10356/1801002024-09-17T01:44:05Z Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy Pemp, Berthold Palkovits, Stefan Sacu, Stefan Schmidl, Doreen Garhöfer, Gerhard Schmetterer, Leopold Schmidt-Erfurth, Ursula School of Chemical and Biomedical Engineering Medicine, Health and Life Sciences Diabetes mellitus Diabetic retinopathy Purpose: Neurovascular coupling impairment and inner retinal layer thinning are early detectable retinal changes in diabetes, and both worsen during progression of diabetic retinopathy (DR). However, direct interactions between these features have not been investigated so far. Therefore, we aimed to analyze associations between the retinal functional hyperemic response to light stimulation and the thickness of individual neuroretinal layers in eyes with early non-proliferative DR. Methods: Thirty patients with type 1 diabetes featuring mild (n = 15) or moderate (n = 15) non-proliferative DR and 14 healthy subjects were included in this cross-sectional study. Retinal vessel diameters were measured before and during illumination with flickering light using a dynamic vessel analyzer. Individual layer thickness in the macula was analyzed from spectral domain optical coherence tomography. Results: Flicker light-induced vessel dilation was significantly reduced in patients compared to healthy controls (veins: 3.0% vs. 6.1%, p < 0.001; arteries: 1.3% vs. 5.1%, p = 0.005). Univariately, the response in retinal veins of diabetes patients correlated significantly with ganglion cell layer (GCL) thickness (r = 0.46, p = 0.010), and negatively with hemoglobin A1c (HbA1c) levels (r=-0.41, p = 0.023) and age (r=-0.38, p = 0.037), but not with baseline diameters, glucose levels, or diabetes duration. In a multiple regression model only GCL thickness (p = 0.017, β = 0.42) and HbA1c (p = 0.045, β=-0.35) remained significantly associated with the vascular flicker light response. Conclusion: The results indicate that thinner GCL and worse glycemic control both contribute to reduced retinal neurovascular coupling in patients with clinical signs of DR. Progression of neurovascular dysfunction in DR might be related to structural degeneration of the neurovascular complex in the inner retina. Published version Open access funding provided by Medical University of Vienna. 2024-09-17T01:44:05Z 2024-09-17T01:44:05Z 2024 Journal Article Pemp, B., Palkovits, S., Sacu, S., Schmidl, D., Garhöfer, G., Schmetterer, L. & Schmidt-Erfurth, U. (2024). Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy. Graefe's Archive for Clinical and Experimental Ophthalmology. https://dx.doi.org/10.1007/s00417-024-06552-4 0721-832X https://hdl.handle.net/10356/180100 10.1007/s00417-024-06552-4 38878068 2-s2.0-85196113117 en Graefe's Archive for Clinical and Experimental Ophthalmology © 2024 The Author(s). Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons. org/licenses/by/4.0/. application/pdf |
| spellingShingle | Medicine, Health and Life Sciences Diabetes mellitus Diabetic retinopathy Pemp, Berthold Palkovits, Stefan Sacu, Stefan Schmidl, Doreen Garhöfer, Gerhard Schmetterer, Leopold Schmidt-Erfurth, Ursula Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy |
| title | Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy |
| title_full | Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy |
| title_fullStr | Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy |
| title_full_unstemmed | Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy |
| title_short | Associations of retinal neurovascular dysfunction with inner retinal layer thickness in non-proliferative diabetic retinopathy |
| title_sort | associations of retinal neurovascular dysfunction with inner retinal layer thickness in non proliferative diabetic retinopathy |
| topic | Medicine, Health and Life Sciences Diabetes mellitus Diabetic retinopathy |
| url | https://hdl.handle.net/10356/180100 |
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