https://doi.org/10.30702/Ophthalmology.2018/08.03

Bezditko P. A.¹, Karliychuk M. A.²

¹Kharkiv National Medical University, Kharkiv, Ukraine
²Higher State Educational Establishment of Ukraine “Bukovinian State Medical University”, Chernivtsi, Ukraine

Abstract. According to the several experimental studies, the biomechanical properties of optic nerve head change in diabetes mellitus (DM) that might be explained by nonenzymatic collagen cross-linking mediated by advanced glycation end products due to high glucose levels in diabetes. Lamina cribrosa morphology is ever changing in health and disease, and its changes might cause primary optic nerve damage and secondary damage due to blood supply decreasing and axoplasmic flow blockade within retinal ganglion cell axons. So, morphological changes of the lamina cribrosa may be a precondition of the optic nerve and retinal ganglion cells damage in DM.

The aim was to define the peculiarities of the ganglion retinal cells complex in patients with diabetes mellitus depending on the scleral lamina cribrosa thickness.

Material and methods of research. 575 patients with type II diabetes were examined. In addition to standard ophthalmologic methods included optical coherent tomography of the retina and optic nerve. In the 1st group (78.9 % of eyes of the patients with DM) a scleral lamina cribrosa mild thickening (< 700 μm) was observed; in 16.6 % of eyes (the 2nd group) a moderate thickening (700–900 μm), and in 3.8 % of eyes (the 3rd group) a significant thickening (< 900 μm) was observed.

Results. Analyzing the index of an average ganglion retinal cell complex in diabetic patients, its dependence on scleral lamina cribrosa thickness was revealed. The average index of ganglion retinal cells global loss volume (GLV) in the 2nd group was 2.9 times higher, in the 3rd group – 5.3 times higher than that in the control group (3.51 ± 2.73 %) (р < 0.001). The focal loss volume (FLV) index of the retinal ganglion cell complex in patients with moderate and significant thickening of the scleral lamina cribrosa was 13.2 and 16.4 times respectively higher than that in healthy individuals (р < 0.001). The highest index of FLV of the retinal ganglion cell complex was observed in the patients of the 3rd group that was 5.9 times higher than that of the 1st group (р < 0.001).

Conclusions. The scientific data about the dependence of the tomographic peculiarities of the optic nerve damage on the scleral lamina cribrosa thickness in diabetic patients were amplified. The focal loss volume index of the retinal ganglion cell complex in patients with moderate and significant thickening of the scleral lamina cribrosa was 13.2 and 16.4 times respectively higher than the corresponding indices in healthy individuals. The index of ganglion retinal cells global loss volume in the patients with scleral lamina cribrosa moderate thickening was 2.9 times higher, in patients with scleral lamina cribrosa significant thickening – 5.3 times higher than that in the healthy individuals.

Keywords: retinal ganglion cell complex, diabetes mellitus, scleral lamina cribrosa.

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Received: 18 Nov 2017

Published: September 2018