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Microalbuminuria Is Associated With Early Retinal Neurodegeneration in Patients With Type 2 Diabetes.

BACKGROUND AND OBJECTIVE
To evaluate retinal layer changes in patients with type 2 diabetes, microalbuminuria, and no diabetic retinopathy, and to investigate its possible relationship with age, gender, diabetes duration, urinary albumin excretion (UAE), glycosylated hemoglobin, and hypertension.


PATIENTS AND METHODS
A prospective, cross-sectional study was performed in 60 patients divided into three groups: diabetic patients with normal UAE, diabetic patients with microalbuminuria, and controls. Retinal thickness was evaluated by Early Treatment Diabetic Retinopathy Study grid using spectral-domain optical coherence tomography.


RESULTS
The average and sectoral macular thicknesses of the ganglion cell layer (GCL) were significantly thinner in the microalbuminuria group compared to normal UAE group and controls (P < .005). UAE was the only factor related to this reduction in a multiple linear regression analysis.


CONCLUSIONS
The GCL thickness was reduced in eyes in patients with type 2 diabetes and microalbuminuria before clinical signs of diabetic retinopathy. Inner retinal neurodegeneration was independently associated with albuminuria. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:e36-e43.].