Application of optical coherence tomography in screening diabetic retinopathy in community

Abstract:

AIM: To investigate the feasibility and significance of the application of optical coherence tomography(OCT)in screening diabetic retinopathy(DR)in community hospitals.

METHODS: Retrospective analysis. A total of 378 cases with type 2 diabetes mellitus in Fushun, 184 males(193 eyes)and 194 females(207 eyes), aged from 43 to 76(averaged 59.0±9.7), were chosen in JiangJun community hospital. According to DR staging standard, 278 patients(300 eyes)with fundus changing were divided into 3 groups: DR1, DR2 and DR3. A total of 100 patients(100 eyes)with no fundus changing were as a control group. Spectralis OCT(Heidelberg, German)was used to scan retina of 3.4mm range around the optic disc with fast scanning mode and the thickness of retinal nerve fiber layer(RNFL)with different areas were recorded. Independent sample t-test and one-way ANOVA were used to compare the difference of RNFL thickness in each group.

RESULTS: The averaged thickness of RNFL in control, DR1, DR2, and DR3 group were 109.52±7.13μm, 108.51±7.09μm, 99.37±8.92μm and 98.48±8.57μm, respectively. Significant differences were found in the RNFL thickness between control group and DR 1-3 group(P<0.05). Comparison of the RNFL thickness in different areas: the distributions of RNFL thickness in control and DR groups were similar, where the RNFL in nasal and temporal optic disc was thinnest and superior and inferior temporal RNFL was thickest. There was statistic difference between the thinnest and thickest RNFL(P<0.05). The differences of the nasal, superior temporal and inferior nasal RNFL were found between DR1 group and control group(P<0.05); the differences of the nasal, superior temporal and inferior nasal RNFL were found between DR2 group and control group(P<0.05); the differences of RNFL in each area were found between DR3 group and control group(P<0.05). No difference of RNFL in each area was found between DR1 and DR2 group(P>0.05); the differences of RNFL in each area were found between DR1 and DR3 group(P<0.05)except temporal RNFL; the differences of RNFL in each area were found between DR2 and DR3 group(P<0.05)except temporal RNFL.

CONCLUSION: The RNFL thickness is one of the sensitive indexes for early diagnosis of DR. The application of OCT in community hospitals for DR screening is helpful to the early prediction and the assessment of DR progression.

Key words:optical coherence tomography; retinal nerve fiber layer thickness; diabetic retinopathy; disease screening; community medical care