Comparative Analysis of Age-Related Macular Degeneration Progression in Diabetic and Non-Diabetic Patients

Abstract

Introduction: With increasing life expectancy and the rising prevalence of Age-related Macular Degeneration (AMD), one of the leading causes of blindness, a deeper understanding of its pathophysiology is essential to enhance prevention, diagnosis, and treatment.

Objective: To compare AMD progression in patients with and without Type 2 Diabetes Mellitus (T2DM) and evaluate vascular and neurodegenerative markers using spectral-domain optical coherence tomography (SD-OCT) during the follow-up period.

Methods: In this retrospective cohort study, 67 AMD patients were included (13 with T2DM and 54 without T2DM). The progression patterns of AMD were analyzed and described. SD-OCT was employed to measure and quantify the thickness of the retina, ganglion cell complex (GCC), and choroid at two time points: the initial visit (V0) and the final visit (V1), with a minimum interval of three years.

Results: In AMD patients without T2DM (mean age 82.81 ± 6.46 years), a reduction in total retinal thickness was observed across all three ETDRS rings. In contrast, AMD patients with T2DM exhibited no significant changes in retinal thickness during the follow-up period (p > 0.05). Regarding total GCC thickness, AMD patients without T2DM showed a significant decrease across all three ETDRS rings (p < 0.001), a change not observed in AMD patients with T2DM (p > 0.05).

Conclusions: Both AMD patient groups, with and without T2DM, demonstrated significant variations in choroidal thickness over the study period. The distinct patterns of thickness variation between the groups suggest a possible influence of diabetes mellitus and its treatment on AMD progression.