Download PDF
J Neurol Surg B Skull Base 2023; 84(02): 194-199
DOI: 10.1055/s-0042-1758146
Original Article

Is There a Relationship between Optic Nerve and Chiasm Measurements with HbA1c Levels in Diabetic Patients?

Pelin Zeynep Bekin Sarıkaya
1   Radiology Department, Kırıkkale University, Faculty of Medicine, Kırıkkale, Turkey
,
Nuray Bayar Muluk 
2   ENT Department, Kırıkkale University, Faculty of Medicine, Kırıkkale, Turkey
,
Adnan Özdemır
1   Radiology Department, Kırıkkale University, Faculty of Medicine, Kırıkkale, Turkey
,
Aşkın Güngüneş
3   Endocrinology and Metabolism Department, Kırıkkale University, Faculty of Medicine, Kırıkkale, Turkey
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Objectives We investigated the optic nerve (ON) and chiasm (OC) in magnetic resonance (MR) in diabetic patients by comparing them with hemoglobin A1c (HbA1c) levels.

Methods In this retrospective study, cranial MRIs of 42 adults (19 males and 23 females) with diabetes mellitus (DM) (group1) and 40 healthy controls (19 males and 21 females) (group 2) were included. In both groups, bilateral ON widths and OC area, width, and height were measured. In the DM group, HbA1c values were also obtained at the time of MRI or within the same month.

Results In the DM group, the mean of the HbA1c values was 8.31 ± 2.51%. There were no significant differences between ON diameter; and OC area, width and height of the DM and control groups (p > 0.05). In each of the DM and control groups, ON diameter was not different between the right and left sides (p > 0.05). In DM groups, correlation tests showed that there were positive correlations between right and left ON diameters, OC area and OC width, and OC height (p < 0.05). In males, ON diameters were higher than those in females bilaterally (p < 0.05). In patients with higher HbA1c values, OC width was smaller (p < 0.05).

Conclusion A significant correlation of OC width and HbA1c levels suggests that uncontrolled DM causes ON atrophy. Our study represents a thorough assessment of OC measures using standard brain MRI to evaluate optic degeneration in DM patients and shows that the OC width measurement is suitable and reliable. This simple method can be obtained from clinically available scans.

Keywords

diabetes mellitus - HbA1c - optic nerve - optic chiasm - atrophy - cranial MRI

Ethics Committee Approval

This study is retrospective. Ethics committee approval was obtained from Kırıkkale University Non-invasive Research Ethics Committee (Date: 27.04.2022, Number: 2022.04.29)


There is no need to take informed consent, because the data was evaluated retrospectively.


There are no funds for this article.


Authors' Contributions

P.Z.B.S. contributed to planning, designing, literature survey, and writing. N.B.M. was involved in planning, designing, literature survey, statistical analysis, writing, and submission. A.O. helped in planning, designing, data collection, and literature survey. A.G. contributed to planning, designing, and literature survey.




Publication History

Received: 20 August 2022

Accepted: 13 September 2022

Article published online:
09 November 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2011; 34 (1, Suppl 1): S62-S69
    CrossrefPubMedGoogle Scholar
  • 2 Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010; 87 (01) 4-14
    CrossrefPubMedGoogle Scholar
  • 3 Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights 2016; 11: 95-104
    CrossrefPubMedGoogle Scholar
  • 4 Yassa ET, Bakbak B. Nöropatilerde Ayırıcı Tanılar: Diyabetik Papillopati, İskemik Optik Nöropati ve Optik Atrofi (Differential Diagnoses in Diabetic Optic Neuropathies: Diabetic Papillopathy, Ischemic Optic Neuropathy and Optic Atrophy). Güncel Retina Dergisi (Current Retina Journal) 2018; 2 (02) 124-129
    PubMedGoogle Scholar
  • 5 Ahmad SS, Kanukollu VM. Optic atrophy. [Updated 2022 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. PMID: 32644556. Accessed October 14, 2022 at: https://www.ncbi.nlm.nih.gov/books/NBK559130/
    Google Scholar
  • 6 American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020 . Diabetes Care 2020; 43 (Suppl. 01) S14-S31
    CrossrefPubMedGoogle Scholar
  • 7 Al-Haddad CE, Sebaaly MG, Tutunji RN. et al. Optic nerve measurement on MRI in the pediatric population: normative values and correlations. AJNR Am J Neuroradiol 2018; 39 (02) 369-374
    CrossrefPubMedGoogle Scholar
  • 8 Lešták J, Kyncl M, Fůs M, Marešová K. Optic chiasm width in normal-tension and high-tension glaucoma. Cesk Slov Oftalmol 2020; 76 (03) 126-128
    PubMedGoogle Scholar
  • 9 Hickman SJ, Brierley CM, Brex PA. et al. Continuing optic nerve atrophy following optic neuritis: a serial MRI study. Mult Scler 2002; 8 (04) 339-342
    CrossrefPubMedGoogle Scholar
  • 10 Trip SA, Schlottmann PG, Jones SJ. et al. Optic nerve atrophy and retinal nerve fibre layer thinning following optic neuritis: evidence that axonal loss is a substrate of MRI-detected atrophy. Neuroimage 2006; 31 (01) 286-293
    CrossrefPubMedGoogle Scholar
  • 11 Liu C, Ji HX, Hu SH, Gong GP, Wei Q, Tian YH. Optic nerve sheath diameter measured using magnetic resonance imaging and factors that influence results in healthy Chinese adults: a cross-sectional study. Chin Med J (Engl) 2021; 134 (18) 2263-2265
    CrossrefPubMedGoogle Scholar
  • 12 Kim DH, Jun JS, Kim R. Measurement of the optic nerve sheath diameter with magnetic resonance imaging and its association with eyeball diameter in healthy adults. J Clin Neurol 2018; 14 (03) 345-350
    CrossrefPubMedGoogle Scholar
  • 13 Chandrapatham K, Cardim D, Czosnyka M. et al. Variability of the optic nerve sheath diameter on the basis of sex and age in a cohort of healthy volunteers. Acta Neurochir Suppl (Wien) 2021; 131: 121-124
    CrossrefPubMedGoogle Scholar
  • 14 Nitin S. HbA1c and factors other than diabetes mellitus affecting it. Singapore Med J 2010; 51 (08) 616-622
    PubMedGoogle Scholar
  • 15 Mostafa SA, Davies MJ, Srinivasan BT, Carey ME, Webb D, Khunti K. Should glycated haemoglobin (HbA1c) be used to detect people with type 2 diabetes mellitus and impaired glucose regulation?. Postgrad Med J 2010; 86 (1021): 656-662
    CrossrefPubMedGoogle Scholar
  • 16 Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies. Diabetes Care 2003; 26 (09) 2653-2664
    CrossrefPubMedGoogle Scholar
  • 17 Ciulla TA, Harris A, Latkany P. et al. Ocular perfusion abnormalities in diabetes. Acta Ophthalmol Scand 2002; 80 (05) 468-477
    CrossrefPubMedGoogle Scholar
  • 18 Miyamoto K, Ogura Y. Pathogenetic potential of leukocytes in diabetic retinopathy. Semin Ophthalmol 1999; 14 (04) 233-239
    CrossrefPubMedGoogle Scholar
  • 19 Jones BV, Barron TF, Towfighi J. Optic nerve enlargement in Krabbe's disease. AJNR Am J Neuroradiol 1999; 20 (07) 1228-1231
    PubMedGoogle Scholar
  • 20 Zhao B, Torun N, Elsayed M. et al. Diagnostic utility of optic nerve measurements with MRI in patients with optic nerve atrophy. AJNR Am J Neuroradiol 2019; 40 (03) 558-561
    PubMedGoogle Scholar