FEATURES OF THE RETINAL MORPHOLOGY CHANGES IN PATIENTS WITH DIABETIC POLYNEUROPATHY DEPENDING ON THE SEVERITY OF THE DISEASE
It is known that diabetic polyneuropathy (DPN) is a risk factor for compromised retinal structural integrity in patients with diabetes, independent of diabetic retinopathy. Given that optical coherent tomography (OCT) can detect diabetes-related compromise in multiple layers of the retina, it is logic to suppose the diagnostic potential of the OCT-derived retinal parameters in differentiating individuals with DPN and evaluation of its severity.
The objective was to study the retinal morphology changes in the patients with diabetic polyneuropathy depending on the severity of the disease by means of an OCT.
Materials and methods of research. 575 patients (1150 eyes) with type II DM and 50 non-diabetic healthy persons (100 eyes) aged 55,9±7,8 years were examined. The features of retinal morphology changes in patients with DPN depending on the severity of the disease were studied by means of OCT of the retina. An average retinal thickness in the fovea, para- and perimacular zones with diameter of examination in 1 mm, 3 mm, 5 mm, respectively were analyzed. The thickness of the retina in the superior and inferior halves, in the temporal, nasal and inferior quadrant of the para- and perimacular zone was determined. In accordance with the classifi cation of DPN, taking into account the severity in 63,5% (365 patients) with DM, the diagnosis of DPN was excluded (stage N0). DPN was diagnosed in 36,5% (210 patients) with DM.
Results. Analyzing the index of the foveal thickness in the patients with the DPN its dependence on the severity of the disease was revealed. The mean foveal thickness in the patients with asymptomatic DPN A, asymptomatic DPN B, and disabling DPN was 9,1%, 8,9%, and 12,7% less than that in age-matched healthy individuals (263,9±25,9 μm) (р<0,05).
In the patients with symptomatic DPN A and B that index had no statistical difference as compared with controls (р>0,05).
The lowest mean foveal thickness was found in the patients with disabling DPN. In symptomatic DPN A, B, and in diabetic patients without DPN this index was 17,0 %, 14,1 % (р<0,001), and 11,0 % (р<0,05) higher than that in disabling DPN. The analysis of the retinal thickness in the superior and inferior halves, in the temporal, nasal and inferior quadrant of the para- and perimacular zones in the patients with DPN did not reveal the dependence on the severity of the disease.
Conclusions. As a result of the studies it was found that a mean foveal thickness in the patients with diabetic polyneuropathy was 9,1%, 8,9%, 12,7% less in patients with asymptomatic A DPN, asymptomatic DPN B, and disabling DPN respectively than that in healthy individuals (р<0,05). A dependence of para- and perimacular retinal thickness on the severity of the diabetic polyneuropathy in the patients with diabetes mellitus was not found.
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