Retinal nerve fibre layer thinning associated with diabetic peripheral neuropathy
Article first published online: 19 JUN 2012
© 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK
Volume 29, Issue 7, pages e106–e111, July 2012
How to Cite
Shahidi, A. M., Sampson, G. P., Pritchard, N., Edwards, K., Vagenas, D., Russell, A. W., Malik, R. A. and Efron, N. (2012), Retinal nerve fibre layer thinning associated with diabetic peripheral neuropathy. Diabetic Medicine, 29: e106–e111. doi: 10.1111/j.1464-5491.2012.03588.x
- Issue published online: 19 JUN 2012
- Article first published online: 19 JUN 2012
- Accepted manuscript online: 24 JAN 2012 06:57AM EST
- Accepted 18 January 2012
- diabetic peripheral neuropathy;
- optical coherence tomography;
- retinal nerve fibre layer thinning
Diabet. Med. 29, e106–e111 (2012)
Aims To investigate the relationship between retinal nerve fibre layer thickness and peripheral neuropathy in patients with Type 2 diabetes, particularly in those who are at higher risk of foot ulceration.
Methods Global and sectoral retinal nerve fibre layer thicknesses were measured at 3.45 mm diameter around the optic nerve head using optical coherence tomography (OCT). The level of neuropathy was assessed in 106 participants (82 with Type 2 diabetes and 24 healthy controls) using the 0–10 neuropathy disability score. Participants were stratified into four neuropathy groups: none (0–2), mild (3–5), moderate (6–8), and severe (9–10). A neuropathy disability score ≥ 6 was used to define those at higher risk of foot ulceration. Multivariable regression analysis was performed to assess the effect of neuropathy disability scores, age, disease duration and retinopathy on RNFL thickness.
Results Inferior (but not global or other sectoral) retinal nerve fibre layer thinning was associated with higher neuropathy disability scores (P = 0.03). The retinal nerve fibre layer was significantly thinner for the group with neuropathy disability scores ≥ 6 in the inferior quadrant (P < 0.005). Age, duration of disease and retinopathy levels did not significantly influence retinal nerve fibre layer thickness. Control participants did not show any significant differences in thickness measurements from the group with diabetes and no neuropathy (P > 0.24 for global and all sectors).
Conclusions Inferior quadrant retinal nerve fibre layer thinning is associated with peripheral neuropathy in patients with Type 2 diabetes, and is more pronounced in those at higher risk of foot ulceration.