Thanh bên bài viết
Số lượt xem PDF: 32
Association between HbA1c level and retinal nerve fiber layer thickness in non-proliferative diabetic retinopathy
Nội dung chính của bài viết
Tóm tắt
Objective: To investigate the association between Hemoglobin A1c (HbA1c) and retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus (DM) at the non-proliferative diabetic retinopathy stage, considering that retinal neurodegeneration is an early event in diabetic retinopathy (DR). Methods: This cross-sectional study included 50 patients with type 2 DM, categorized into without diabetic retinopathy (NDR, n=30) and non-proliferative diabetic retinopathy (NPDR, n=20) groups. Peripapillary RNFL thickness was measured using spectral-domain optical coherence tomography (SD-OCT). Systemic data, including HbA1c, blood pressure, BMI, and DM duration, were collected and analyzed for correlations. Results: The NPDR group exhibited a significantly longer DM duration, higher systolic blood pressure, and elevated HbA1c levels compared to the NDR group (p<0.05). Average RNFL thickness was significantly lower in the NPDR group for both the right (94.3 ± 5.53 µm vs. 100.77 ± 5.26 µm, p<0.001) and left eyes (95.0 ± 5.38 µm vs. 100.27 ± 6.65 µm, p=0.005). A significant negative correlation was found between average RNFL thickness and HbA1c levels, duration of DM, and systolic blood pressure. Conclusion: RNFL thinning is a significant structural change in early DR, strongly associated with poor glycemic control, longer disease duration, and elevated systolic blood pressure. These findings highlight the potential of RNFL thickness as a biomarker for early neurodegeneration and emphasize the importance of managing systemic risk factors.
Chi tiết bài viết
Từ khóa
Diabetic Retinopathy, Retinal Nerve Fiber Layer, HbA1c, Neurodegeneration, Optical Coherence Tomography, Type 2 Diabetes.
Tài liệu tham khảo
2. Kropp, M., Golubnitschaja, O., Mazurakova, A., Koklesova, L., Sargheini, N., Vo, T. K. S., de Clerck, E., Polivka, J., Jr., Potuznik, P., Polivka, J., Stetkarova, I., Kubatka, P., & Thumann, G. (2023). Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications-risks and mitigation. EPMA J, 14(1), 21-42. https://doi.org/10.1007/s13167-023-00314-8
3. Ma, D., Deng, W., Khera, Z., Sajitha, T. A., Wang, X., Wollstein, G., Schuman, J. S., Lee, S., Shi, H., Ju, M. J., Matsubara, J., Beg, M. F., Sarunic, M., Sappington, R. M., & Chan, K. C. (2024). Early inner plexiform layer thinning and retinal nerve fiber layer thickening in excitotoxic retinal injury using deep learning-assisted optical coherence tomography. Acta Neuropathol Commun, 12(1), 19. https://doi.org/10.1186/s40478-024-01732-z
4. Pandey, S., Mishra, D., Singh, T. B., Tiwari, P., Manisha, Ekagrata, & Parihar, S. (2024). Correlation of glycosylated hemoglobin (HbA1c) with retinal nerve fiber layer (RNFL) thickness and central macular thickness (CMT) in the diabetic population in North India. Indian J Ophthalmol, 72(8), 1186-1191. https://doi.org/10.4103/IJO.IJO_2981_23
5. Rasul, A., Rashid, A., Waheed, P., & Khan, S. A. (2018). Expression analysis of glyoxalase I gene among patients of diabetic retinopathy. Pak J Med Sci, 34(1), 139-143. https://doi.org/10.12669/pjms.341.13839
6. Shi, R., Guo, Z., Wang, F., Li, R., Zhao, L., & Lin, R. (2018). Alterations in retinal nerve fiber layer thickness in early stages of diabetic retinopathy and potential risk factors. Curr Eye Res, 43(2), 244-253. https://doi.org/10.1080/02713683.2017.1387669
7. Wan, Z. Q., Gao, Y., Cui, M., & Zhang, Y. J. (2021). Association between risk factors and retinal nerve fiber layer loss in early stages of diabetic retinopathy. Int J Ophthalmol, 14(2), 255-262. https://doi.org/10.18240/ijo.2021.02.12
8. Zhang, H., Wang, J., Ying, G. S., Shen, L., & Zhang, Z. (2014). Diabetic retinopathy and renal function in Chinese type 2 diabetic patients. Int Urol Nephrol, 46(7), 1375-1381. https://doi.org/10.1007/s11255-014-0675-4