Early neural retinal changes in type 2 Diabetes Mellitus

• Grant number: 11/12482-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: December 01, 2011
• End date: May 31, 2013
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Michel Eid Farah
• Grantee: Müller Gonçalves Urias
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Diabetic retinopathy (DR) is one of the leading causes of blindness in the labor age in developed countries. With clinical onset classically associated with vascular disorders, DR has treatments that have been shown limited and, sometimes, hold the little gain. Nevertheless, studies have indicated that neural loss may also occur in a very early stage of DR, even before any sign of vasculopathy can be observed. This cross-sectional study aims to verify neural retinal changes previous to microangiopathy in patients with type 2 diabetes mellitus, having no clinical DR or with initial DR. Patients will be classified into three groups of 40 individuals each, consisting of (a) normal (control); ( b) patients with diabetes and no retinopathy; (c) patients with diabetes and initial DR. Subjects, recruited from the outpatient clinic of Federal University of São Paulo (UNIFESP), will be characterized according to (1) time of diabetes, (2) use of insulin (yes or no) and time of use, (3) last glucose, (4) last glycosylated hemoglobin, (5) systemic hypertension (yes or no), (6) nephropathy (yes or no), (7) best-corrected visual acuity, (8) lens status. Patients will be imaged with Fluorescein Angiography and with Spectral-Domain Optical Coherence Tomography (OCT) Cirrus" (Carl Zeiss Meditec, Dublin, CA, USA). Image data from the SD-OCT will be subjectively examined by two observers and objectively analyzed through software, then statistically cross, next to each patient's demographic variables. This study claims to improve the early diagnosis of DR, seeking the possibility of more effective treatments before major changes in the retina.(AU)