{"title":"Longitudinal neural and microvascular changes in type 2 diabetic patients without retinopathy: a 2-year prospective cohort study.","authors":"Yiran Fan,Lingyi Li,Xinyan Wu,Yayi Yan,Pan Li,Likun Lin,Yuntong Li,Ching-Kit Tsui,Kaiqun Liu,Wenyong Huang,Xiaoling Liang,Andina Hu, ","doi":"10.1016/j.ajo.2025.09.025","DOIUrl":null,"url":null,"abstract":"PURPOSE\r\nTo compare the 2-year longitudinal changes in macular ganglion cell-inner plexiform layer thickness (GCIPLT) and superficial capillary plexus (SCP) vessel density between patients with type 2 diabetes mellitus (T2DM) without retinopathy (non-DR) and healthy controls.\r\n\r\nDESIGN\r\nProspective observational cohort study.\r\n\r\nMETHODS\r\nT2DM patients without clinical retinopathy at baseline and after a 2-year follow-up, along with age- and sex-matched healthy controls, were recruited from the community in Guangzhou. Measurements of macular GCIPLT, retinal thickness (RT), and SCP vessel density were conducted at baseline and at the 2-year follow-up. Linear mixed-effects models were used to estimate absolute and relative rates of changes and to compare absolute rates between the two groups.\r\n\r\nRESULTS\r\nA total of 282 eyes (141 in the control group and 141 in the non-DR group) were included in the analysis. Significant reductions in GCIPT and GCIPLT/RT occurred only in the non-DR group, with GCIPLT decreasing by -0.229 μm/year (95% confidence interval [CI]: -0.313 to -0.144; P < 0.001) and 0.324 % (95%CI: 0.444 to 0.204; P < 0.001), approximately 5-fold faster than the control group. After adjusting for confounding factors, the longitudinal rates of RT, GCIPLT, and GCIPLT/RT were significantly accelerated in the non-DR group compared to the control group by -0.603 μm/year (95% CI: -0.939 to -0.268; P < 0.001), -0.189 μm/year (95% CI: -0.306 to -0.073; P = 0.001), and -0.073 % (95% CI: -0.118 to -0.028; P = 0.001), respectively. While, longitudinal changes in SCP vessel density did not show significant differences between the two groups (P = 0.861).\r\n\r\nCONCLUSIONS\r\nOur findings suggest that neurodegenerative changes may precede microvascular alterations in non-DR patients, indicating that monitoring of GCIPLT is crucial for patients with long-standing diabetes, even in the absence of retinopathy.","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":"196 1","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajo.2025.09.025","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
PURPOSE
To compare the 2-year longitudinal changes in macular ganglion cell-inner plexiform layer thickness (GCIPLT) and superficial capillary plexus (SCP) vessel density between patients with type 2 diabetes mellitus (T2DM) without retinopathy (non-DR) and healthy controls.
DESIGN
Prospective observational cohort study.
METHODS
T2DM patients without clinical retinopathy at baseline and after a 2-year follow-up, along with age- and sex-matched healthy controls, were recruited from the community in Guangzhou. Measurements of macular GCIPLT, retinal thickness (RT), and SCP vessel density were conducted at baseline and at the 2-year follow-up. Linear mixed-effects models were used to estimate absolute and relative rates of changes and to compare absolute rates between the two groups.
RESULTS
A total of 282 eyes (141 in the control group and 141 in the non-DR group) were included in the analysis. Significant reductions in GCIPT and GCIPLT/RT occurred only in the non-DR group, with GCIPLT decreasing by -0.229 μm/year (95% confidence interval [CI]: -0.313 to -0.144; P < 0.001) and 0.324 % (95%CI: 0.444 to 0.204; P < 0.001), approximately 5-fold faster than the control group. After adjusting for confounding factors, the longitudinal rates of RT, GCIPLT, and GCIPLT/RT were significantly accelerated in the non-DR group compared to the control group by -0.603 μm/year (95% CI: -0.939 to -0.268; P < 0.001), -0.189 μm/year (95% CI: -0.306 to -0.073; P = 0.001), and -0.073 % (95% CI: -0.118 to -0.028; P = 0.001), respectively. While, longitudinal changes in SCP vessel density did not show significant differences between the two groups (P = 0.861).
CONCLUSIONS
Our findings suggest that neurodegenerative changes may precede microvascular alterations in non-DR patients, indicating that monitoring of GCIPLT is crucial for patients with long-standing diabetes, even in the absence of retinopathy.
期刊介绍:
The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect.
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