Retinal neurodegeneration in patients with type 2 diabetes mellitus without diabetic retinopathy

Arch Soc Esp Oftalmol (Engl Ed). 2022 Apr;97(4):205-218. doi: 10.1016/j.oftale.2022.02.009. Epub 2022 Mar 2.

Abstract

In diabetes mellitus (DM) patients retinal complications were typically considered part of a vascular process. Recent research suggests that retinal degeneration in DM might also be caused by a neuropathy that could precede microvascular alterations. The present work reviews the currently available bibliography about neurodegeneration in patients with type 2 DM (DM2) without diabetic retinopathy (DR). In patients with non-severe, early DM2 without DR and good metabolic control visual function parameters show early abnormalities that precede clinical DR (in which we diagnose with a conventional ophthalmological examination). Using optical coherence tomography (OCT) technology, a reduction in macular and peripapillary thickness has been observed in different studies. Recent researches suggest that systemic complications (especially ischaemia) and a possible microvascular alteration eventually contributes to retinal neurodegeneration, which opens the door to new studies that include new techniques for evaluating the microvascularization of the retinal layers.

Keywords: Capa de células ganglionares; Capa de fibras nerviosas de la retina; Diabetes mellitus tipo 2; Ganglion cell layer; Neurodegeneración; Neurodegeneration; Optical coherence tomography; Retinal nerve fibre layer; Swept-source technology; Tecnología Swept-Source; Tomografía de coherencia óptica; Type 2 diabetes mellitus.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / etiology
  • Humans
  • Retina
  • Tomography, Optical Coherence / methods
  • Vision, Ocular