{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:10Z","timestamp":1787028670454,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,8]],"date-time":"2019-09-08T00:00:00Z","timestamp":1567900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI15\/0625"],"award-info":[{"award-number":["PI15\/0625"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI12\/0183"],"award-info":[{"award-number":["PI12\/0183"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Recent studies have shown that retinal neurodegeneration may precede visible vascular changes in diabetic retinopathy (DR). In addition, the relationship of choroidal thickness (CT) with DR stage is not well defined. To assess the inner retinal and choroidal structural changes in type 1 diabetic subjects (T1D), a cross-sectional study was conducted in 242 T1D patients and in 69 age-matched, non-diabetic individuals. The nasal retinal nerve fibre layer (RNFL) thickness was lower in T1D patients without DR (p &lt; 0.001), with mild DR (p &lt; 0.001), and with advanced DR (p &lt; 0.001) compared to control subjects. The ganglion cell layer (GCL) thickness was lower in T1D patients with advanced DR compared to those with mild DR (p = 0.003) and without DR (p &lt; 0.001) and compared to the control subjects (p &lt; 0.001). T1D subjects with no DR and mild DR had higher CT than the control subjects, but the CT in T1D patients with advanced DR was lower (p = 0.038) than that in T1D subjects with mild DR and was not significantly different from that of the control subjects. In conclusion, T1D subjects showed a significant thinning of the nasal RNFL in the early stages of the disease, even before any vascular changes in the retina. A decrease in the GCL thickness during advanced DR stages was observed. Choroidal thickness was higher in T1D subjects without DR and in early DR stages but decreased in advanced stages.<\/jats:p>","DOI":"10.3390\/jcm8091412","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T04:12:40Z","timestamp":1568002360000},"page":"1412","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Assessment of Inner Retinal Layers and Choroidal Thickness in Type 1 Diabetes Mellitus: A Cross-Sectional Study"],"prefix":"10.3390","volume":"8","author":[{"given":"Marc","family":"Carbonell","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain"},{"name":"Department of Surgery, Barcelona Autonomous University (UAB), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N\u00faria","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital and Health Science Research Institute Germans Trias i Pujol, 08916 Badalona, Spain"},{"name":"Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), 08907 Barcelona, Spain"},{"name":"Department of Medicine, Barcelona Autonomous University (UAB), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2061-6270","authenticated-orcid":false,"given":"Esmeralda","family":"Castelblanco","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), 08907 Barcelona, Spain"},{"name":"Department of Endocrinology &amp; Nutrition, Hospital de la Santa Creu i Sant Pau &amp; Institut d\u2019Investigaci\u00f3 Biom\u00e8dica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain"},{"name":"DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundaci\u00f3 Institut Universitari per a la Recerca a l\u2019Atenci\u00f3 Prim\u00e0ria de Salut Jordi Gol i Gurina (IDIAPJGol), 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5979-8948","authenticated-orcid":false,"given":"Jordi","family":"Real","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), 08907 Barcelona, Spain"},{"name":"DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundaci\u00f3 Institut Universitari per a la Recerca a l\u2019Atenci\u00f3 Prim\u00e0ria de Salut Jordi Gol i Gurina (IDIAPJGol), 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Ram\u00edrez-Morros","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, University Hospital and Health Science Research Institute Germans Trias i Pujol, 08916 Badalona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0475-3096","authenticated-orcid":false,"given":"Rafael","family":"Sim\u00f3","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), 08907 Barcelona, Spain"},{"name":"Department of Endocrinology and Nutrition, Hospital Universitari Vall d\u2019Hebron, Diabetes and Metabolism Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3109-1721","authenticated-orcid":false,"given":"Cristina","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), 08907 Barcelona, Spain"},{"name":"Department of Endocrinology and Nutrition, Hospital Universitari Vall d\u2019Hebron, Diabetes and Metabolism Research Unit, Vall d\u2019Hebron Institut de Recerca (VHIR), Universitat Aut\u00f2noma de Barcelona, 08035 Barcelona, Catalonia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carme","family":"Jurjo","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Arnau de Vilanova, 25198 Lleida, Spain"},{"name":"Biomedical Research Institute of Lleida (IRBLleida) &amp; University of Lleida, 25198 Lleida, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al\u00edcia","family":"Traveset","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Arnau de Vilanova, 25198 Lleida, Spain"},{"name":"Biomedical Research Institute of Lleida (IRBLleida) &amp; University of Lleida, 25198 Lleida, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Valldeperas","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Hospital Germans Trias i Pujol, 08916 Badalona, Spain"},{"name":"Department of Surgery, Barcelona Autonomous University (UAB), 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2868-0250","authenticated-orcid":false,"given":"D\u00eddac","family":"Mauricio","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), 08907 Barcelona, Spain"},{"name":"Department of Medicine, Barcelona Autonomous University (UAB), 08035 Barcelona, Spain"},{"name":"Department of Endocrinology &amp; Nutrition, Hospital de la Santa Creu i Sant Pau &amp; Institut d\u2019Investigaci\u00f3 Biom\u00e8dica Sant Pau (IIB Sant Pau), 08041 Barcelona, Spain"},{"name":"DAP-Cat Group, Unitat de Suport a la Recerca Barcelona, Fundaci\u00f3 Institut Universitari per a la Recerca a l\u2019Atenci\u00f3 Prim\u00e0ria de Salut Jordi Gol i Gurina (IDIAPJGol), 08025 Barcelona, Spain"},{"name":"Biomedical Research Institute of Lleida (IRBLleida) &amp; University of Lleida, 25198 Lleida, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16012","DOI":"10.1038\/nrdp.2016.12","article-title":"Diabetic retinopathy","volume":"17","author":"Wong","year":"2016","journal-title":"Nat. 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