Correlation between Macular GCIPL Thickness and Visual Acuity after Resolution of Diabetic Macular Edema

Park Ji Man; Young Chang Lee; Seong Taeck Kim

doi:10.3341/jkos.2015.56.9.1345

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Ji Man, Lee, and Kim: Correlation between Macular GCIPL Thickness and Visual Acuity after Resolution of Diabetic Macular Edema

Original Article

J Korean Ophthalmol Soc 2015;56(9):1345-1352.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.9.1345

Correlation between Macular GCIPL Thickness and Visual Acuity after Resolution of Diabetic Macular Edema

Park Ji Man, M.D¹, Young Chang Lee, M.D, PhD², Seong Taeck Kim, M.D, PhD^1,

¹Department of Ophthalmology, Chosun University School of Medicine, Gwangju, Korea

²I Clinic, Gwangju, Korea

Address reprint requests to Seong Taeck Kim, MD, PhD Department of Ophthalmology, Chosun University Hospital, #365 Pilmun-daero, Hak-dong, Dong-gu, Gwangju 61453, Korea Tel: 82-62-220-3190, Fax: 82-62-225-9839 E-mail: s20age@hanmail.net

Received 27 March 201522 June 2015 Accepted 14 August 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell-inner plexiform lay-er (mGCIPL) thickness in eyes with resolved diabetic macular edema (DME).

Methods

Twenty eyes of diabetic retinopathy patients with resolved DME (DME group) after treatment, and 20 eyes of diabetic retinopathy patients without DME (no-DME group) were included in this study. The pRNFL thickness, mGCIPL thickness and central macular thickness (CMT) were measured using spectral-domain optical coherence tomography (SD-OCT). Analyses were performed to determine the correlation between the different thicknesses and the visual function.

Results

No significant difference in mean CMT was observed between the DME and no-DME groups. Average pRNFL thick-ness in the DME group was thicker than in the no-DME group ( p = 0.003). Average mGCIPL thickness in the DME group was thinner than in the no-DME group ( p = 0.030). Final visual acuity was significantly correlated with average mGCIPL thickness and minimum mGCIPL thickness, but not pRNFL thickness and CMT in the DME group.

Conclusions

mGCIPL thickness decreased in the DME group compared with the no-DME group and was correlated with the vis-ual acuity. These results suggested that inner retinal injury in patients with DME might lead to poor visual outcome after treatment.

Keywords: Diabetic macular edema (DME), Ganglion cell-inner plexiform layer (GCIPL), Optical coherence tomography (OCT)

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Figure 1.

Scatter plot of end-point BCVA (log MAR) versus average pRNFL thickness, temporal pRNFL thickness, average GCIPL thickness, minimum GCIPL thickness and average CMT in DME eyes (n = 20). (A) Correlation between average pRNFL thickness and end-point BCVA. (B) Correlation between temporal pRNFL thickness and end-point BCVA. (C) Correlation between average GCIPL thickness and end-point BCVA. (D) Correlation between minimum GCIPL thickness and end-point BCVA. (E) Correlation between average CMT and end-point BCVA. BCVA = best corrected visual acuity; pRNFL = peripapillary retinal nerve fiber lay-er; GCIPL = Ganglion cell-inner plexiform layer; CMT = central macular thickness; DME = diabetic macular edema.

Table 1.

Clinical characteristics of eyes with DME group and no-DME group

Baseline characteristics	DME (n = 20)	No-DME (n = 20)	p-value
Age (years)	59.32 ± 11.69	60.46 ± 13.35	0.782
Sex (M/F)	9/11	10/10
BCVA (log MAR)	0.68 ± 0.23	0.35 ± 0.17	<0.001
SE (D)	0.02 ± 1.56	-0.11 ± 1.65	0.807
Duration of DM (years)	15.45 ± 5.19	11.67 ± 8.99	0.171
HbA1C (%)	8.12 ± 1.94	7.93 ± 1.27	0.775
NPDR/PDR	12/8	10/10	0.525
Duration of DME (months)	8.25 ± 8.93	N/A
Injection (B/TA/B + TA)	16/1/3	N/A
CMT (μ m)	253.17 ± 18.94	255.23 ± 18.37	0.724

Values are presented as mean ± SD unless otherwise indicated. DME = diabetic macular edema; M = male; F = female; BCVA = best corrected visual acuity; SE = spherical equivalent; DM = diabetes mellitus; NPDR = non proliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy; B = bevacizumab; TA = triamcinolone acetonide; CMT = central macular thickness; N/A = not available.

Table 2.

Comparison of pRNFL parameter between eyes with DME group and no-DME group measured by Cirrus OCT

Thickness (μ m)	DME (n = 20)	No-DME (n = 20)	p-value
Average pRNFL	101.3 ± 17.0	94.5 ± 6.6	0.003
Superior	123.2 ± 19.8	119.3 ± 11.2	0.257
Inferior	126.9 ± 26.9	122.6 ± 14.1	0.382
Temporal	88.0 ± 21.4	71.8 ± 9.9	<0.001
Nasal	67.3 ± 20.9	64.3 ± 10.0	0.378

Values are presented as mean ± SD unless otherwise indicated. pRNFL = peripapillary retinal nerve fiber layer; DME = diabetic macular edema; OCT = optical coherence tomography.

Table 3.

Comparison of mGCIPL parameter between eyes with DME group and no-DME group measured by Cirrus OCT

Thickness (μ m)	DME (n = 20)	No-DME (n = 20)	p-value
Average GCIPL	71.4 ± 18.7	82.2 ± 10.3	0.030
Minimum GCIPL	50.0 ± 25.1	67.7 ± 18.4	0.015
Superotemporal	72.2 ± 21.3	82.7 ± 10.8	0.059
Superior	70.6 ± 23.9	80.6 ± 16.1	0.128
Superonasal	72.9 ± 18.2	80.9 ± 15.7	0.145
Inferonasal	73.0 ± 17.9	82.6 ± 15.6	0.079
Inferior	71.9 ± 24.2	83.3 ± 13.7	0.077
Inferotemporal	73.1 ± 23.1	83.2 ± 13.1	0.097

Values are presented as mean ± SD unless otherwise indicated. mGCIPL = macular ganglion cell-inner plexiform layer; DME = diabetic macular edema; OCT = optical coherence tomography; GCIPL = ganglion cell-inner plexiform layer.

Table 4.

Comparison of mGCIPL parameter and CMT between PRP group and no-PRP group measured by Cirrus OCT

Thickness (μ m)	DME (n = 20)			No-DME (n = 20)
Thickness (μ m)	No-PRP (n = 7)	PRP (n = 13)	p-value	No-PRP (n = 9)	PRP (n = 11)	p-value
Average GCIPL	74.2 ± 20.6	66.3 ± 14.5	0.384	80.8 ± 7.8	83.5 ± 12.6	0.573
Minimum GCIPL	54.7 ± 27.3	41.3 ± 18.9	0.265	62.1 ± 12.7	73.3 ± 22.0	0.185
CMT	249.4 ± 21.7	259.9 ± 10.3	0.248	261.1 ± 19.4	249.2 ± 16.0	0.152

Values are presented as mean ± SD unless otherwise indicated. mGCIPL = macular ganglion cell-inner plexiform layer; CMT = central macular thickness; PRP = panretinal photocoagulation; OCT = opti-cal coherence tomography; DME = diabetic macular edema; GCIPL = ganglion cell-inner plexiform layer.

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