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Journal of Diabetes Research
Volume 2013, Article ID 905058, 8 pages
Clinical Study

Retinal Layers Changes in Human Preclinical and Early Clinical Diabetic Retinopathy Support Early Retinal Neuronal and Müller Cells Alterations

1Department of Ophthalmology, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
2Fondazione G. B. Bietti, Via Livenza 3, 00198 Roma, Italy

Received 8 March 2013; Revised 17 May 2013; Accepted 20 May 2013

Academic Editor: Ahmed M. Abu El-Asrar

Copyright © 2013 Stela Vujosevic and Edoardo Midena. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To evaluate the changes in thickness of individual inner and outer macular and peripapillary retinal layers in diabetes. Methods. 124 subjects (124 eyes) were enrolled: 74 diabetics and 50 controls. Macular edema, proliferative diabetic retinopathy (DR), any intraocular treatment and refractive error diopters were the main exclusion criteria. Full ophthalmic examination, stereoscopic fundus photography, and spectral domain-OCT were performed. After automatic retinal segmentation (layering) in 5 layers, the thickness of each layer was calculated, and values compared among groups. Results. Thirty patients had no DR, 44 patients had non proliferative DR. A significant increase of inner plexiform and nuclear layers was found in DR eyes versus controls ( ). A significant decrease ( ) of retinal nerve fiber layer (RNFL) and at specific sites of retinal ganglion cell layer ( ) was documented in the macula. In the peripapillary area there were no differences between diabetics and controls. Conclusions. Decreased RNFL thickness and increased INL/OPL thickness in diabetics without DR or with initial DR suggest early alterations in the inner retina. On the contrary, the outer retina seems not to be affected at early stages of DM. Automatic intraretinal layering by SD-OCT may be a useful tool to diagnose and monitor early intraretinal changes in DR.