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Comparison of the nerve fiber layer of type 2 diabetic patients without glaucoma with normal subjects of the same age and sex

Authors Takis A, Alonistiotis D, Panagiotidis D, Ioannou N, Papaconstantinou D, Theodossiadis P

Received 8 May 2013

Accepted for publication 20 July 2013

Published 25 February 2014 Volume 2014:8 Pages 455—463

DOI https://doi.org/10.2147/OPTH.S47762

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Alexandros Takis,1 Dimitrios Alonistiotis,1 Dimitrios Panagiotidis,1 Nikolaos Ioannou,1 Dimitris Papaconstantinou,2 Panagiotis Theodossiadis1

1Ophthalmological University Clinic of Athens, Attikon Hospital, Athens, Greece; 2Ophthalmological University Clinic of Athens, Geniko Kratiko Hospital, Athens, Greece

Background: The retinal nerve fiber layer (RNFL) thickness in patients with diabetes mellitus type 2 was compared to normal subjects of similar age and sex, having first excluded any risk factors for glaucoma. The correlation between the RNFL thickness and the severity of diabetic retinopathy was investigated at its primary stages and with other ocular and diabetic parameters.
Methods: A prospective, case series study was carried out. Twenty-seven diabetic patients without diabetic retinopathy, 24 diabetic patients with mild retinopathy, and 25 normal, age-matched subjects underwent a complete ophthalmological examination and imaging with scanning laser polarimetry for the evaluation of the RNFL. Multivariate analysis was applied in order to investigate the correlation between RNFL and diabetic parameters, such as age, duration of diabetes, insulin therapy, levels of glycosylated hemoglobin; and ocular parameters, such as cup to disc ratio, levels of normal intraocular pressure, and central corneal thickness.
Results: The mean inferior average of RNFL and the temporal-superior-nasal-inferior-temporal standard deviation were statistically significantly lower in both diabetic groups, and the nerve fiber index was higher (P=0.04) compared to the normal group. There was no statistically significant difference between the diabetic groups. The factor analysis showed no significant correlation between the RNFL and the previously mentioned diabetic and ocular parameters.
Conclusion: The existence of diabetes should be seriously considered in evaluating the results of scanning laser polarimetry. Multivariate analysis for RNFL was used for the first time.

Keywords: diabetes, glaucoma, RNFL, SLP

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