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Comparative Analysis of Optical Coherence Tomography Parameters in Type 2 Diabetes Mellitus Patients With and Without Retinopathy in Trinidad and Tobago

diabetes-and-endocrinology
evidence-based-medicine
global-health
ophthalmology

Abstract

Background: Diabetic retinopathy (DR) is a leading cause of vision loss in individuals with diabetes. Its prevalence is increasing globally, including in Trinidad and Tobago, where the burden of type 2 diabetes mellitus (T2DM) is particularly high. OCT provides detailed retinal imaging and may aid in the early detection of structural changes. This study aimed to compare OCT parameters among patients with T2DM with and without retinopathy and non-diabetic controls to identify potential early biomarkers of DR.
Methods: A cross-sectional study was conducted among 104 participants attending the Optometric Eye Clinic of the University of the West Indies. The cohort included 70 non-diabetic controls, 16 patients with T2DM without retinopathy, and 18 patients with T2DM with varying stages of DR. The clinical evaluation included glycated hemoglobin (HbA1c) testing, functional vision assessments, biometry, and comprehensive OCT imaging. The OCT parameters were compared between the groups using independent t-tests and one-way analysis of variance with Bonferroni corrections.
Results: ANOVA revealed significant group differences in most OCT parameters (p < 0.001), except the left eye vertical disc diameter (p = 0.006). Compared to controls, T2DM patients without DR exhibited higher cup-to-disc ratios (0.44 ± 0.19) and vertical CD ratios (1.34 ± 0.46) in the right eye (p = 0.007 and p = 0.021, respectively). Healthy controls demonstrated greater rim area (1.62 ± 0.25) and superior thickness (132.51 ± 7.94 μm) in the left eye compared to patients with T2DM without DR (both p < 0.001). In contrast, the disc area and total thickness in the right eye were significantly larger in patients with T2DM without DR (p = 0.006 and p = 0.036, respectively). Patients with DR showed broader abnormalities, including increased cup area, cup volume, CD ratios, and reduced rim and retinal thickness, compared with both controls and patients with T2DM without DR.
Conclusion: OCT detected significant structural differences across all groups, including early changes in patients with T2DM without retinopathy. These findings underscore the potential of OCT as a sensitive tool for the early detection and monitoring of DR progression, supporting its integration into screening and management strategies for DM in populations with a high prevalence of T2DM.
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