Nervous and Vascular Alterations of the Retina in Diabetic Patients without Retinopathy
DOI:
https://doi.org/10.71413/wepa1844Keywords:
Retina, Diabetes Mellitus, Diabetic Retinopathy, Retinal AlterationsAbstract
Relevance: The importance of contributing to the diagnosis of alterations in the structure of the retina before the onset of diabetic retinopathy.
Purpose: To determine the nervous and vascular alterations of the retina in diabetic patients without retinopathy.
Methods: An exploratory, observational, descriptive, cross-sectional study was carried out in diabetic patients without retinopathy, in the Retina service of the Cuban Institute of Ophthalmology: Ramón Pando Ferrer.
Results: The nerve fiber layer in most subfields showed a difference in terms of thickening for the study group patients, the ganglion cell layer did show a significant decrease. Macular thickness showed a relevant decrease in the central and internal subfields. The macula showed a decrease in vascular density, where area and circularity decreased, not the perimeter.
Conclusions: In patients without diabetic retinopathy, the nervous and vascular alteration is associated in most cases with a decrease in the ganglion cell layer and microcirculation of the superficial plexus of the macula.
References
Zimmet P, Alberti kgmm, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414: 782-6. [citado 21 abril 2023]. DOI: https://doi.org/10.1038/414782a
International Diabetes Federation. IDF Diabetes Atlas. 7a ed. Brussels, Belgium: IDF Executive Office; 2015. [citado 19 abril 2023].
International Diabetes Federation (IDF). IDF Diabetes Atlas 10th edition.idf.org. 2021. [citado 19 abril 2023].
Noda Alonso S. Diabetes Mellitus: comorbilidad a tener en cuenta en tiempos de COVID-19. 2021. [citado 19 abril 2023]. DOI: https://doi.org/10.2307/j.ctv2zp4xbt.23
Álvarez-Vazquez L, Arnold Dominguez Y. Envejecimiento poblacional y efecto en la diabetes mellitus en Cuba. Rev Cientif. 2016;26(1):71-7. [citado 19 abril 2023]. DOI: https://doi.org/10.54495/Rev.Cientifica.v26i1.83
Organización mundial de la salud. Informe mundial sobre el envejecimiento y la salud. 2015 [citado 21 abril 2023].
Ministerio de Salud Pública. Anuario estadístico de Salud 2020. La Habana 2019 [citado 21 abril 2023].
Jiménez V, Verano N, Rodríguez J, Sánchez A, Espinosa L. Factores cardioaterogénicos y riesgo cardiovascular en diabéticos tipo 2 hospitalizados. Rev Cub Med Mil. 2018;47(2):21-5. [citado 21 abril 2023].
Llorente CY, Soca PE, Rivas VD, Borrego CY. Factores de riesgo asociados con la aparición de diabetes mellitus tipo 2 en personas adultas. Rev Cuba Endoc. 2016;27(2):26-30. [citado 21 abril 2023].
Yanes M, Cruz J, González T. Educación terapéutica sobre diabetes a adultos mayores. Rev Cub Endocrinol. 2018;29(3):29-34. [citado 21 abril 2023
Weng W, Kong SX, Ganguly R, Hersloev M, Brett J, Hobbs T, et al. The prevalence of cardiovascular disease by vascular bed and impact on healthcare costs in a large, real-world population with type 2 diabetes. Endocrinol Diabetes Metab. 2019;3(2):106-10. DOI: https://doi.org/10.1002/edm2.106
Díaz Díaz O, Orlandi Gonzalez N. Manual para el diagnóstico y tratamiento del paciente diabético a nivel primario de salud. Edición OPS/OMS en Cuba; 2013. [citado 4 mayo 2023].
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014;37(SUPPL.1). [citado 4 mayo 2023]. DOI: https://doi.org/10.2337/dc14-S081
GBD 2019 Blindness and Visual Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Causes of blindness and visual impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: The Right to Sight: an analysis for the Global Burden of Disease Study. Lancet Global Health. 2021 Feb;9(2):e144-e160. doi: 10.1016/S2214-109X(20)30489-7 DOI: https://doi.org/10.1016/S2214-109X(20)30489-7
Rodríguez Rodríguez BN, Ríos Torres M, Padilla González CM, Barroso Lorenzo R, et al. Diabetic Retinopathy in Patients Over 50 Years Old in Cuba during 2016. 2021 EC Ophthalmology Volume12(12): 71-80. [citado 4 mayo 2023].
Early Treatment Diabetic Retinopathy Study Research Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. ETDRS report number 2. Ophthalmology. 1987; 94(7): 761-74. DOI: https://doi.org/10.1016/S0161-6420(87)33527-4
Global Diabetic Retinopathy Project Group. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003; 110 (9): 1677-82. DOI: https://doi.org/10.1016/S0161-6420(03)00475-5
Sachdeva MM. Retinal Neurodegeneration in Diabetes: an Emerging Concept in Diabetic Retinopathy. Curr Diab Rep. 2021 Dec 13;21(12):65. DOI: https://doi.org/10.1007/s11892-021-01428-x
Li, X., Yu, Y., Liu, X. et al. Quantitative analysis of retinal vessel density and thickness changes in diabetes mellitus evaluated using optical coherence tomography angiography: a cross-sectional study. BMC Ophthalmol 21, 259 (2021). DOI: https://doi.org/10.1186/s12886-021-01988-2
Carpineto P, Toto L, Aloia R, Ciciarelli V, Borrelli E, Vitacolonna E, Di Nicola M, Di Antonio L, Mastropasqua R. Neuroretinal alterations in the early stages of diabetic retinopathy in patients with type 2 diabetes mellitus. Eye (Lond). 2016 May;30(5):673-9. DOI: https://doi.org/10.1038/eye.2016.13
Van Dijk HW, Verbraak FD, Kok PH, Garvin MK, Sonka M, et all. Decreased retinal ganglion cell layer thickness in patients with type 1 diabetes. Invest Ophthalmol Vis Sci. 2010 Jul;51(7):3660-5. DOI: https://doi.org/10.1167/iovs.09-5041
Sohn EH, Van Dijk HW, Jiao CH, Kok PHB, Jeong W, Nazli Demirkaya N and et all. Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus. PNAS. Published online, 2016. [citado 4 mayo 2023]. DOI: https://doi.org/10.1073/pnas.1522014113
Arevalo JF,Agüero CA, Arzabe CW, Lavaque A, Brim NR, Roca JA, Wu L. Manual de oftalmología Angio –OCT. Producido por PAAO. 2018[citado 4 mayo 2023].
PAAO. RETINA PAAO 2019. I.S.B.N.: 978-99974-0-980-5 [citado 4 mayo 2023].
CIRRUS HD-OCT User Manual – Models 500, 5000. [citado 4 mayo 2023].
Rio Torres M. Prevalencia de ceguera en ciudad de la habana. [tesis] 2010 [citado 12 de febrero de 2023]. Instituto Cubano de Oftalmología Ramón Pando Ferrer. La Habana.
OMS. Salud ocular universal: un plan de acción mundial para 2014-2019. [pft] 2013. [citado 12 de junio de 2023]
Rodríguez Rodríguez BN. Discapacidad visual en el adulto diabético en cuba [tesis] Instituto Cubano de Oftalmología Ramón Pando Ferrer. La Habana. 2017 [citado 12 de febrero de 2023].
Rodríguez Rodríguez B, Rodríguez Rodríguez V, Chiang Rodríguez C, Alemañi Rubio E, García Ferrer L, Galindo Reymond K, et all. Estudio rápido de prevención de discapacidad visual en diabéticos del municipio de playa. Rev Cubana Oftalmol. 2017;30 (2):1-11.
Ambiya V, Kumar A, Bhavaraj VR, Sharma V, Sharma N. Study of inner retinal neurodegeneration in Diabetes Mellitus using spectral domain optical coherence tomography. Eur J Ophthalmol. 2022 Sep;32(5):3074-3081. DOI: https://doi.org/10.1177/11206721211048793
Additional Files
Published
Issue
Section
Categories
License
Copyright (c) 2025 MSc. Eumelia Carrillo Suárez, Dra. Beatriz N. Rodríguez Rodríguez, Dr. Rafael Ernesto González Días, MSc. Inalvis Suárez Cuza, MSc. Yenelis Molina Santana (Autor/a)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Make a Submission
Language
Search
