Peculiarities of peripapillary neuronal changes in patients with axial diabetic optic neuropathy depending on the stage of the disease
Background. It is known that focal loss volume of the ganglion retinal cell complex can differentiate individuals with peripheral diabetic neuropathy from healthy controls, while the inferior retinal nerve fiber layer thickness helps differentiate those with greater degrees of neuropathy from those with mild neuropathy or without this disease. However, literature sources do not describe the nature of peripapillary retinal nerve fiber changes, depending on the stage of axial diabetic optic neuropathy (DON). The purpose was to analyze the features of changes in peripapillary retinal nerve fibers in patients with axial DON, depending on the stage of the disease. Materials and methods. The analysis of the peculiarities of changes in peripapillary retinal nerve fibers was performed on the basis of the data of a survey of 280 patients (460 eyes) with axial DON aged 55.9 ± 7.8 years. Subclinical stage of DON was observed in 50.2 % (231 eyes) of patients with axial DON, initial stage — in 20.7 % (95 eyes), advanced stage — in 19.8 % (91 eyes), dystrophic stage — in 9.3 % (43 eyes). For comparison, we used data from a group of 50 healthy control patients (100 eyes). In addition to routine eye examination, optical coherence tomography of the retina and optic nerve was performed. An average peripapillary retinal nerve fiber layer thickness and thickness of this layer in the superior and inferior hemispheres were analyzed. Results. As a result of studies performed in patients with axial diabetic optic neuropathy, it was found that peripapillary retinal nerve fiber layer thickness at the advanced stage of axial DON was 38.7 % higher, while in the subclinical, initial and dystrophic stages of axial DON it was lower by 8.0, 13.8, 20.5 %, respectively, than in healthy individuals. A moderate thickening of peripapillary retinal nerve fibers was noted in patients with the advanced stage of axial DON, moderate thinning of peripapillary retinal nerve fibers is detected at the subclinical stage of axial DON, significant thinning — at the initial and dystrophic stages of axial DON. Conclusions. From the obtained results it was found that the features of peripapillary neuronal changes depended on the stage of axial diabetic optic neuropathy.
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