RETINAL NEURONAL DAMAGE IN DIABETES AND DIABETIC RETINOPATHY USING OPTICAL COHERENCE TOMOGRAPHY

Abstract

Diabetic retinopathy (DR), a potentially blinding disease, is clinically characterized by apparent microvascular lesions. New insights into retinal physiology suggest that DR is a neurovascular disease with retinal neuronal damage. Retinal ganglion cells (RGCs) are the output neurons and their damage in diabetes and DR can be assessed using optical coherence tomography (OCT) quantified as thinning of the inner retinal layers. Differences in OCT algorithms have given rise to calculations of different RGC parameters. In this thesis, spectral-domain OCT for the assessment of RGCs will be applied in observational studies to demonstrate the following: (1) RGC evaluation should be represented by separate measurements of ganglion cell-inner plexiform layer (GC-IPL) and retinal nerve fibre layer thicknesses; (2) Thinning of the GC-IPL is associated with diabetes and no DR, and increased DR severity, suggesting that RGC neuronal damage quantified using OCT may be integrated into the clinical detection and monitoring of DR.