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Purpose <p>In this study, we aimed to identify subclinical retinal and choroidal changes in patients with type 2 diabetes mellitus without diabetic retinopathy (NDR) over two years and evaluate the risk factors associated with diabetic retinal neurodegeneration (DRN).</p> Methods <p>In this prospective cohort study, retinal and choroidal thicknesses were measured using optical coherence tomography (OCT), and OCT angiography was used to analyze vessel density.</p> Results <p>Among 8020 eyes, 6644 were control eyes, and 1376 were NDR eyes, with 808 eyes completing the 2-year follow-up assessment. The NDR group exhibited significantly thinner overall retinal thickness (RT), ganglion cell-inner plexiform layer, and choroidal thickness compared to the control group (<i>P</i> = 0.043, <i>P</i> = 0.013, and <i>P</i> = 0.031, respectively). Additionally, the NDR group showed significant annual thinning in 3-mm overall RT, retinal nerve fiber layer, and ganglion cell complex thickness, with losses of − 1.14&#xa0;μm/y, − 0.27&#xa0;μm/y, and − 0.62&#xa0;μm/y, respectively. Factors such as age, female sex, cardiovascular events, and axial length were negatively associated with DRN.</p> Conclusion <p>Our patient cohort demonstrated that DRN precedes the microvascular changes characteristic of DR and progresses over time. Choroidal morphological features were altered and may correspond to DRN.</p>

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Retinal and choroidal changes in diabetic patients before definitive diagnosis of diabetic retinopathy: a two-year prospective study

  • 期刊论文

  • 发表日期：

    2026年2月27日

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  • Mingming Ma,
  • Yanfei Feng,
  • Juping Liu,
  • Fei Gao,
  • Emmanuel Eric Pazo,
  • Xiaomin Zhang,
  • Xiaorong Li

摘要

Purpose

In this study, we aimed to identify subclinical retinal and choroidal changes in patients with type 2 diabetes mellitus without diabetic retinopathy (NDR) over two years and evaluate the risk factors associated with diabetic retinal neurodegeneration (DRN).

Methods

In this prospective cohort study, retinal and choroidal thicknesses were measured using optical coherence tomography (OCT), and OCT angiography was used to analyze vessel density.

Results

Among 8020 eyes, 6644 were control eyes, and 1376 were NDR eyes, with 808 eyes completing the 2-year follow-up assessment. The NDR group exhibited significantly thinner overall retinal thickness (RT), ganglion cell-inner plexiform layer, and choroidal thickness compared to the control group (P = 0.043, P = 0.013, and P = 0.031, respectively). Additionally, the NDR group showed significant annual thinning in 3-mm overall RT, retinal nerve fiber layer, and ganglion cell complex thickness, with losses of − 1.14 μm/y, − 0.27 μm/y, and − 0.62 μm/y, respectively. Factors such as age, female sex, cardiovascular events, and axial length were negatively associated with DRN.

Conclusion

Our patient cohort demonstrated that DRN precedes the microvascular changes characteristic of DR and progresses over time. Choroidal morphological features were altered and may correspond to DRN.