https://doi.org/10.30702/Ophthalmology30062021-13.2.14-23/833-007.17
UDC 617.736-007.7:616.379-008.64:616.833-007.17

Karliychuk M. A.¹, Bezditko P. A.², Pinchuk S. V.³

¹Radzikhovskiy Department of Ophthalmology, Bukovinian State Medical University, Chernivtsi, Ukraine
²Ophthalmology Department of the Kharkiv National Medical University, Kharkiv, Ukraine
³Eye Microsurgery Center Vash Zir, Chernivtsi, Ukraine

Abstract. Diabetic polyneuropathy (DPN) is one of the most common complications of diabetes mellitus (DM), affecting up to a quarter of all patients with DM, and in asymptomatic form it is present in all patients. A number of changes in the retina, optic nerve, corneal nerve fibers, and visual function may correlate with DPN, so their evaluation may provide additional information on the detection and determination of its severity.

The aim. To determine the peculiarities of changes in morphometric parameters of the central zone of the retina depending on the severity of DPN.

Materials and methods. In total, 575 patients with type II DM were examined (1150 eyes). In 365 (63.5 %) DM patients, the diagnosis of DPN was excluded (stage N0). DPN was diagnosed in 210 (36.5 %) DM patients. Asymptomatic DPN was observed in 101 (17.5 %) DM patients: N1A stage – in 47 (8.1 %) patients, N1B stage – in 54 (9.4 %) patients; symptomatic DPN – in 89 (15.5 %) DM patients: N2A stage – in 46 (8.0 %) patients, N2B stage – in 43 (7.5 %) patients; stage of severe complications (N3 stage) – in 20 (3.5 %) DM patients. The control group consisted of 50 healthy individuals (100 eyes). In addition to standard ophthalmic examination methods, optical coherent tomography of the retina and optic nerve was performed.

Results. Patients with type 2 DM had morphometric features of macular lesions depending on the severity of DPN: the index of focal loss volume (FLV) of retinal ganglion cells was 8.4 times higher in asymptomatic stage A DPN, 8.7 times higher in asymptomatic stage B DPN, 14.1 times higher in symptomatic stage A DPN, 14.3 times higher in symptomatic stage B DPN, 15.3 times higher at the stage of severe DPN complications (p <0.05), and the thickness of the retina in the foveolar zone in patients with asymptomatic stage A DPN was 9.1 % lower, with asymptomatic stage B DPN it was 8.9 % lower, and at the stage of severe complications of DPN it was 12.7 % lower than the respective indices in healthy age-matched individuals.

Conclusions. The obtained data indicate the relationship between morphometric parameters of the macula and the severity of DPN. The identified morphometric features of the macula in type 2 DM can serve as a non-invasive ophthalmic biomarker of the severity of DPN.

Keywords: macula, optical coherent tomography, diabetic polyneuropathy, severity.