International Journal of Advances In Case Reports

A COMPARATIVE STUDY OF THE ROLE OF RETINAL NERVE FIBER LAYER THICKNESS MEASURED BY OPTICAL COHERENCE TOMOGRAPHY VERSUS NERVE CONDUCTION VELOCITY FOR EARLY DIAGNOSIS OF PERIPHERAL NEUROPATHY IN TYPE TWO DIABETES MELLITUS

Mohmad Saada, Wael Gabrb*, Osama MMA. El-Azouni c, Enaase A.M.E.d , Ahmed Elbablye

waaael@gmail.com

Diabetes mellitus, Optical coherence tomography, Peripheral neuropathy, Diabetic neuropathy, Nerve conduction study.

Diabetic neuropathy may carry the risk of more complications and even mortality in patients with diabetes mellitus. Current techniques for early clinical assessment of diabetic peripheral neuropathy (DPN) are either relatively insensitive or invasive. There is a need for non-invasive, safe evaluation methods. Recently many studies evaluate the retina as an important site for the diagnosis and monitoring of (diabetic peripheral neuropathy) DPN. This study aim is to evaluate retinal nerve fiber layer (RNFL) thickness assessed by optical coherence tomography (OCT) in early detection of DPN compared with currently used golden standard methods. Thirty-eight diabetic patients were assessed clinically for neuropathy using neuropathy Mitchigan score and nerve conduction study of sural, popliteal and ulnar nerves. The subjects were divided into diabetic patients with neuropathy (patient group) and diabetic patients without neuropathy (control group); the patient group was further subdivided into mild, moderate and severe groups according to Toronto clinical neuropathy score system (TCSS). The RNFL thickness was measured in both groups. In our study twenty patients have DPN, in which RNFL thinning was demonstrated in both peripapillary and macular areas compared with the controls, and was more prominent in the inferior half. Moreover; the inferior macular RNFL thinning was statistically significant in patients with mild DPN compared with the control; whereas the nerve conduction study (NCS) failed to differentiate between mild diabetic neuropathy patient and control group. The RNFL thickness in type 2 diabetes mellitus significantly reduced with the severity of DPN and it can be used for early detection of DPN before the appearance of the NCS abnormalities.