Early visual cortical structural changes in diabetic patients without diabetic retinopathy

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 255; no. 11; pp. 2113 - 2118
• Main Authors: Ferreira, Fábio S., Pereira, João M. S., Reis, Aldina, Sanches, Mafalda, Duarte, João V., Gomes, Leonor, Moreno, Carolina, Castelo-Branco, Miguel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2017; Springer Nature B.V
• Subjects: Adult; Aged; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2 - diagnosis; Diabetic Retinopathy; Disease Progression; Female; Follow-Up Studies; Gray Matter - diagnostic imaging; Humans; Information processing; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Morphometry; Neuroimaging; Occipital lobe; Ophthalmology; Retina; Retina - diagnostic imaging; Retinal Disorders; Retinopathy; Substantia grisea; Time Factors; Visual cortex; Visual Cortex - diagnostic imaging; Type 2 diabetes; VBM; Diabetic retinopathy; DARTEL; T1-w sMRI
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-017-3752-4

Background
It is known that diabetic patients have changes in cortical morphometry as compared to controls, but it remains to be clarified whether the visual cortex is a disease target, even when diabetes complications such as retinopathy are absent. Therefore, we compared type 2 diabetes patients without diabetic retinopathy with control subjects using magnetic resonance imaging to assess visual cortical changes when retinal damage is not yet present.
Methods
We performed T1-weighted imaging in 24 type 2 diabetes patients without diabetic retinopathy and 27 age- and gender-matched controls to compare gray matter changes in the occipital cortex between groups using voxel based morphometry.
Results
Patients without diabetic retinopathy showed reduced gray matter volume in the occipital lobe when compared with controls.
Conclusions
Reduced gray matter volume in the occipital cortex was found in diabetic patients without retinal damage. We conclude that cortical early visual processing regions may be affected in diabetic patients even before retinal damage occurs.