The changes of the retinal layers in diabetic patiens with retinopathy

Summary Purpose Retinal neurodegeneration and inflammation are considered early events in diabetic retinopathy(DR). Herein are described changes, in retinal glial and neuronal cells, with spectral domain(SD‐OCT) in patients with non proliferative DR. Methods 130 subjects were evaluated:88 diabetics with DR and 42 normals.All subjects underwent full ophthalmologic examination and SD‐OCT. After automatic retinal segmentation in 5 layers, the thickness of each layer was calculated and compared. Intraretinal hyperreflective spots(HRS) were evaluated on linear scans. Results A significant increase in inner nuclear (INL) and outer plexiform(p < 0.01) and decrease in retinal nerve fiber layer (RNFL) thickness (p < 0.01) was found in DR eyes (without DME) vs controls.HRS number was significantly higher in diabetics with DR with or without DME vs controls,(p < 0.05). HRS number increased with progressing DR. Conclusion Selective thinning of inner retina in the macula, suggesting an early neuronal loss(accompanied by Muller cells activation with increased INL thickness) in DR is reported. HRS increase and migration to outer retina, may represent a surrogate of microglial activation.SD‐OCT may be useful in detecting intraretinal changes in DR.