Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus

Diabetic retinopathy (DR) has long been recognized as a microvasculopathy, but retinal diabetic neuropathy (RDN), characterized by inner retinal neurodegeneration, also occurs in people with diabetes mellitus (DM). We report that in 45 people with DM and no to minimal DR there was significant, progressive loss of the nerve fiber layer (NFL) (0.25 μm/y) and the ganglion cell (GC)/inner plexiform layer (0.29 μm/y) on optical coherence tomography analysis (OCT) over a 4-y period, independent of glycated hemoglobin, age, and sex. The NFL was significantly thinner (17.3 μm) in the eyes of six donors with DM than in the eyes of six similarly aged control donors (30.4 μm), although retinal capillary density did not…

• UD
  U.S. Department of Veterans Affairs
• RT
  Research to Prevent Blindness
• AA
  Arnold and Mabel Beckman Initiative for Macular Research
• Z
  ZonMw
• NI
  National Institutes of Health

  Award: R01EB004640
• NE
  National Eye Institute

  Awards: R01EY018853, R01EY017066, R01EY019112, R01EY016379
• NI
  National Institute of Biomedical Imaging and Bioengineering

  Award: R01EB004640