Diabetes-related retinal ganglion cell loss starts early
Retinal ganglion cell loss due to type 1 diabetes begins in early childhood and is detectable by OCT before any sign of diabetic retinopathy occurs, according to a study.
Sixty children with type 1 diabetes without diabetic retinopathy and 60 matched controls without diabetes were included. Age in both groups ranged between 10 and 17 years. Spectral domain OCT technology was used to measure ganglion cell-inner plexiform layer (GC-IPL) thickness and retinal nerve fiber layer (RNFL) thickness.
Children with diabetes had a significantly lower GC-IPL thickness in all quadrants, except the superior nasal quadrant, as compared with healthy children. RNFL thickness was comparable in both groups. An inverse correlation was found between blood glucose level and the GC-IPL thickness in certain quadrants of patients with diabetes, whereas no correlation was found between the duration of diabetes and GC-IPL or RNFL thickness.
According to the authors, these data suggest that only ganglion cells are affected in the early stages of type 1 diabetes, while changes in RNFL thickness occur in adulthood. The early correlation with blood glucose level, on the other hand, highlights the importance of blood glucose control with intensive insulin treatment for type 1 diabetes during early childhood.
This study also highlights the value of SD-OCT as a means to detect early structural changes in the retina that would go undetected using ophthalmoscopic examinations.
The authors suggested that “the decreased GC-IPL thickness results from neurodegenerative effects on the retina that probably occur prior to vasculopathy in the early stages of childhood diabetes” and said that further studies are needed to verify these results. – by Michela Cimberle
Disclosure: The authors report no relevant financial disclosures.