The Association of Grades of Photoreceptor Inner Segment-Ellipsoid Band Disruption with Severity of Retinopathy in Type 2 Diabetes Mellitus

A prospective case-control study was undertaken to evaluate the association of inner segment-ellipsoid (ISel) band disruption with severity of diabetic retinopathy on spectral-domain optical coherence tomography. ISel disruption was graded as - grade 0: intact ISel; grade 1: focal disruption (subfoveal ISel disruption) and grade 2: global disruption (ISel disruption involving macular cube). Increased severity of diabetic retinopathy was found to be associated with increase in disruption of ISel (r = 0.49, p < 0.001). 'Global' disruption of ISel in proliferative diabetic retinopathy (PDR) (n=40) was significantly higher as compared non proliferative diabetic retinopathy (NPDR) (n=40) (Intact/Focal/Global: 5/25/10 (NPDR) vs. 0/11/29 (PDR), χ2=19.70; p<0.0001). Decrease in visual acuity was found to be significantly associated with increased disruption of ISel and severity of retinopathy.