IJRETINAIJRETINA

International Journal of RetinaInternational Journal of Retina

Introduction: Prevention of Diabetic Retinopathy (DR) require an examination method that can identify earliest damage before clinical symptoms observed. This study aimed to determine the novel and objective way to detect those damage through RNFL and GCL-IPL thickness.. . Methods: This analytical cross sectional study research conducted at the eye polyclinic and the Diabetic Center of IGNG Ngoerah Hospital, Denpasar. This study comparing the difference in thickness of RNFL and GCL-IPL in patients without DM, with Type 2 DM without DR and with DR in average and each quadrant through Kruskal Wallis and One Way Anova test.. . Results: The sample was 59 people which then divided into three groups, namely 20 samples in the group without DM, 19 samples in the DM group without DR and 20 samples with DR. The samples were then examined for RNFL and GCL-IPL and the results were compared between groups. The mean age of the subjects were 58.80±9.65 years old. In the RNFL measurement, it was found that there were differences in values between groups in all quadrants except the temporal quadrant (p=0.518). After covariate analysis by variables of age, HbA1c, blood pressure, visual acuity, IOP and axial length, the results change with the nasal and inferior quadrants as the only found significant. In the GCL-IPL analysis there were significant differences between groups, especially in the superotemporal, temporal and inferotemporal quadrants (p<0.005). These results remained after being controlled by covariate analysis.

This study proved a neurodegeneration process that occurred focally in certain areas that can be detected through the RNFL and GCL-IPL measurement modalities.These examinations were expected to be useful in terms of screening both primary and secondary in patients with type 2 DM.The study highlights the importance of considering vascular factors over metabolic control in understanding neurodegeneration.Further research is needed to investigate the relationship between retinal nerve fiber layer thickness and diabetic retinopathy progression.

Berdasarkan hasil penelitian ini, beberapa saran penelitian lanjutan dapat diajukan. Pertama, penelitian prospektif jangka panjang diperlukan untuk mengkonfirmasi hubungan kausal antara perubahan mikrovaskular dan kerusakan neurodegeneratif pada pasien diabetes. Kedua, studi lebih lanjut perlu dilakukan untuk mengeksplorasi peran faktor vaskular dibandingkan faktor metabolik dalam perkembangan neurodegenerasi pada diabetes, dengan fokus pada analisis mendalam terhadap parameter seperti kepadatan pembuluh darah dan zona avaskular fovea. Ketiga, penelitian yang melibatkan subkelompok pasien dengan berbagai tingkat keparahan retinopati diabetik, termasuk yang telah menjalani prosedur laser atau injeksi intravitreal, dapat memberikan pemahaman yang lebih komprehensif tentang perubahan pada lapisan saraf retina dan ganglion. Penelitian ini dapat diperluas dengan mengukur fungsi visual, seperti pemeriksaan lapang pandang, sensitivitas kontras, dan persepsi warna, untuk mengidentifikasi korelasi antara perubahan struktural dan fungsional pada retina.

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