Macular thinning in prediabetes or type 2 diabetes without diabetic retinopathy: the Maastricht Study

作者：De Clerck Eline E. B.^*; Schouten Jan S. A. G.; Berendschot Tos T. J. M.; Goezinne Fleur; Dagnelie Pieter C.; Schaper Nicolaas C.; Schram Miranda T.; Stehouwer Coen D. A.; Webers Carroll A. B.

来源：Acta Ophthalmologica, 2018, 96(2): 174-182.

DOI：10.1111/aos.13570

• neurodegeneration
• optical coherence tomography
• retina
• type 2 diabetes

PurposeTo assess macular thinning in individuals with prediabetes or type 2 diabetes without diabetic retinopathy (DM2 w/o DR) compared with individuals with normal glucose metabolism (NGM).
MethodsUsing spectral domain optical coherence tomography (SD-OCT), we measured macular thickness in six subfields as defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) in 1838 participants from The Maastricht Study, a population-based cohort study (mean age 598years, 49% men, 1087 NGM, 279 prediabetes, 472 DM2 w/o DR). Multivariable linear regression was used to assess the association between macular thickness and glucose metabolism status.
ResultsAfter adjustment for age, sex and spherical equivalent, individuals with prediabetes showed a significant decrease in pericentral superior macular thickness [=-2.14m (95% confidence interval (CI): -4.24 to -0.03), p<0.05] compared with individuals with NGM. In individuals with DM2 w/o DR, the fovea [=-4.05m (95% CI: -6.30 to -1.79), p<0.001] and the four pericentral quadrants (range: =-4.64 to -5.29m, p<0.001) were significantly thinner compared with individuals with NGM. There was a significant linear trend of macular thinning with severity of glucose metabolism status in five subfields (p<0.001).
ConclusionMacular thickness is reduced in prediabetes and a greater reduction occurs in DM2, even before DR is clinically present. About half of the thinning observed in DM2 w/o DR was already found in prediabetes. Generalized thinning of the macula could be related to thinning of the temporal side of the optic nerve head through the connecting papillo-macular bundle.

• 出版日期2018-3