The Relationship Between Tumor Necrosis Factor-Alpha (TNF-α) with Retinal Nerve Fiber Layer (RNFL) Thickness in Diabetic Retinopathy Patients at Prof. CPL Universitas Sumatera Utara General Hospital and Affiliated Hospital
Article Sidebar
-
Diabetes mellitus, diabetic retinopathy, TNF-α, RNFL layer
Abstract
Introduction: Retinal neurodegeneration may be an early indicator of diabetic retinopathy, the second most common complication after nephropathy. Tumor Necrosis Factor-Alpha (TNF-α) plays a role in the pathogenesis of inflammatory and neovascular eye disorders and is associated with intraocular inflammatory diseases like macular edema and proliferative diabetic retinopathy. This study aims to find the relationship between TNF-α levels and Retinal Nerve Fiber Layer (RNFL) thickness in diabetic retinopathy patients at Prof. CPL Universitas Sumatera Utara General Hospital and affiliated hospital.
Methods: This cross-sectional study included 45 patients with type 2 DM and diabetic retinopathy at Prof. CPL Universitas Sumatera Utara General Hospital and affiliated hospital from March to June 2024. RNFL and posterior segment examinations were conducted. TNF-α levels were measured from blood samples.Blood sugar data were taken from medical records.
Results: Of the 45 participants, 24 were men (53.3%) and 21 women (46.7%). 32 (71.1%) had DM for >5 years, and 27 (60%) experienced PDR. Highest location for RNFL thickness examination was superior (19, 42.2%). Average TNF-α with thin RNFL was 65.67 ng/L, and with thick RNFL was 64.78 ng/L. Mean TNF-α with thin superior RNFL was 65.74 ng/L, and thick was 63.70 ng/L. Mean TNF-α with thin inferior RNFL was 65.73 ng/L, and thick was 63.9 ng/L. Mean TNF-α with thin temporal RNFL was 68.73 ng/L, and thick was 67.19 ng/L. Mean TNF-α with thick nasal RNFL was 67.06 ng/L.
Conclusion: There was no statistically significant relationship between TNF-α and RNFL thickness in diabetic retinopathy patients.
Full text article
References
Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022 Sep;18(9):525-539. doi: 10.1038/s41574-022-00690-7. Epub 2022 Jun 6. PMID: 35668219; PMCID: PMC9169030.
Lin KY, Hsih WH, Lin YB, Wen CY, Chang TJ. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy. J Diabetes Investig. 2021;12(8):1322-1325. doi:10.1111/jdi.13480
Wong TY, Cheung CM, Larsen M, Sharma S, Simó R. Diabetic retinopathy. Nat Rev Dis Primers. 2016;2:16012. Published 2016 Mar 17. doi:10.1038/nrdp.2016.12
PERDAMI. Pedoman Nasional Pelayanan Kedokteran Retinopati Diabetika. Persatuan Dokter Spesialis Mata Indonesia Kementerian Kesehatan Republik Indonesia 2018. 2022
Sasongko MB, Widyaputri F, Agni AN, et al. Prevalence of Diabetic Retinopathy and Blindness in Indonesian Adults With Type 2 Diabetes. Am J Ophthalmol. 2017;181:79-87. doi:10.1016/j.ajo.2017.06.019
Lin KD, Hsu CC, Ou HY, Wang CY, Chin MC, Shin SJ. Diabetes-related kidney, eye, and foot disease in Taiwan: An analysis of nationwide data from 2005 to 2014. J Formos Med Assoc. 2019;118 Suppl 2:S103-S110. doi:10.1016/j.jfma.2019.07.027
Song SJ, Han K, Choi KS, et al. Trends in diabetic retinopathy and related medical practices among type 2 diabetes patients: Results from the National Insurance Service Survey 2006-2013. J Diabetes Investig. 2018;9(1):173-178. doi:10.1111/jdi.12655
Nilay A, Thool AR. A Review of Pathogenesis and Risk Factors of Diabetic Retinopathy With Emphasis on Screening Techniques. Cureus. 2022;14(11):e31062. Published 2022 Nov 3. doi:10.7759/cureus.31062
Ezhilvendhan K, Shenoy A, Rajeshkannan R, Balachandrachari S, Sathiyamoorthy A. Evaluation of Macular Thickness, Retinal Nerve Fiber Layer and Ganglion Cell Layer Thickness in Patients among Type 2 Diabetes Mellitus Using Optical Coherence Tomography. J Pharm Bioallied Sci. 2021;13(Suppl 2):S1055-S1061. doi:10.4103/jpbs.jpbs_165_21
Gong X, Wang W, Xiong K, et al. Associations Between Peripapillary Retinal Nerve Fiber Layer and Choroidal Thickness With the Development and Progression of Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2022;63(2):7. doi:10.1167/iovs.63.2.7
Lim HB, Shin YI, Lee MW, Park GS, Kim JY. Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness of Patients With Type 2 Diabetes. JAMA Ophthalmol. 2019;137(10):1125-1132. doi:10.1001/jamaophthalmol.2019.2537
Lee MW, Lim HB, Kim MS, et al. Effects of prolonged type 2 diabetes on changes in peripapillary retinal nerve fiber layer thickness in diabetic eyes without clinical diabetic retinopathy. Sci Rep. 2021;11(1):6813. Published 2021 Mar 24. doi:10.1038/s41598-021-86306-y
Yao Y, Li R, Du J, et al. Tumor necrosis factor-α and diabetic retinopathy: Review and meta-analysis. Clin Chim Acta. 2018;485:210-217. doi:10.1016/j.cca.2018.06.028
Yavuz NC, Ozer MA, Sari IF, Kulakli S, Tatli S, Ogut H. Optical coherence tomography changes in ankylosing spondylitis patients on long-term adalimumab treatment. Rev Assoc Med Bras (1992). 2022;68(12):1626-1630. Published 2022 Nov 25. doi:10.1590/1806-9282.20220052
Sahin AK, Etgü F, Uzun A. Assessment of central retinal thickness, choroidal thickness, and retinal nerve fiber layer in psoriasis: a spectral-domain optical coherence tomography study. BMC Ophthalmol. 2021;21(1):233. Published 2021 May 26. doi:10.1186/s12886-021-02000-7
Roy MS, Roy A, Brown S. Increased urinary-free cortisol outputs in diabetic patients. J Diabetes Complications. 1998;12(1):24-27. doi:10.1016/s1056- 8727(97)00006-8
Hang H, Yuan S, Yang Q, Yuan D, Liu Q. Multiplex bead array assay of plasma cytokines in type 2 diabetes mellitus with diabetic retinopathy. Mol Vis. 2014;20:1137-1145. Published 2014 Aug 4.
Sentani MP, Zulkifli Y, Nilapsari R. Karakteristik Retinopati Diabetik pada Pasien Diabetes Melitus Tipe 2 di RSAU dr. M. Salamun. Universitas Islam Bandung. 2017. E-ISSN: 2460-657X.
Novianti W. Hubungan Kejadian Retinopati Diabetik dengan Jenis Kelamin pada Pasien Diabetes Melitus Tipe 2 (Studi Observasional Analitik di SEC RSI Sultan Agung Semarang Tahun 2021). Unissula Institutional Repository. 2023.
Primaputri A, Irmandha S, Karim M, et al. Hubungan Jenis Retinopati Diabetik dengan Lama Menderita Diabetes Melitus dan Kadar HBA1C. Fakumi Medical Journal Vol 2 No.8. 2022 Agustus. 585-591. E-ISSN: 2808-9146.
Mehboob MA, Amin ZA, Islam QU. Comparison of retinal Nerve Fiber Layer Thickness Between Normal Population and Patients with Diabetes Mellitus Using Optical Coherence Tomography. Pakistan Journal of Medical Sciences. 2019. Jan-Feb; 35(1): 29-33. doi: 10.12669/pjms.35.1.65 PMCID: PMC6408645 PMID: 30881391.
Dwijayanti S. Hubungan Perfusi Retina Peripapiler Dengan Ketebalan Retinal Nerve Fiber Layer Peripapiler Pada Pasien Diabetes Melitus Tanpa Retinopati Diabetika. Universitas Padjajaran. 2020.
De Swapan K, Devadas Krishnakumar, Notkins Abner L. Elevated Levels Of Tumor Necrosis Factor Alpha (TNF- α) in Human Immunodeficiency Virus Type 1-Transgenic Mice: Prevention of Death by Antibody to TNF-α. Journal of Virology. 2002 Nov.76(22): 11710-11714. doi: 10.1128/JVI.76.22.11710-11714.2002.
Panchenko MV, Nikolaienko MM, Honchar OM et al. Serum TNF-α and IL-1β levels in patients with RNFL thinning in uveitis complicated by optic nerve inflammation. Journal of Ophthalmology (Ukraine). 2020. Number 6 (497). ISSN: 0030-0675.
Authors
Copyright (c) 2025 Wahyu Medsa Yeltas Putra, Delfi, Taufik Ashar
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.