الفهرس 
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Abstract
Diabetic retinopathy (DR) is the leading cause of visual impairment in the working age population.
Degeneration of retinal neurons and glial cells has been postulated recently in the pathogenesis of diabetic retinopathy.
These abnormalities were described even before the development of microaneurysms.
Researches on the pathogenesis of DR found that neuronal dysfunction and neurodegeneration are closely correlated with microvascular dysfunction.
Chronic hyperglycemia, even without clinically detectable microvascular complications, can lead to the impairment of retinal ganglion cell layer and so to a reduction of GC-IPL thickness.
Objective assessment of GC-IPL thickness is important in DR as it will help in detection of inner retinal loss associated with the disease and help in developing neuroprotective therapeutic regimens. Detecting early impairment of neurologic tissue in DR can allow a preventive rather than interventional approach in treatment and then a better visual prognosis for these patients. [12]
GC-IPL thinning has been found in retinal illnesses. In recent studies, it was reported that GC-IPL thickness values were markedly reduced in diabetic eyes without DR and it was concluded that neuroretinal alterations may precede micro vascular abnormalities in diabetic eyes.
Summary
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This study evaluates ganglion cell complex (GCC) thickness in diabetic patient without retinopathy by using spectral-domain optical coherence tomography.
The included participants in the study undergone full ophthalmological examination as Best corrected visual acuity measurement using snellen eye chart then converted into log MAR,Intraocular pressure measurement by goldman applanation tonometer,Anterior segment examination by slit lamp, Posterior segment examination after pupillary dilation using Slit lamp biomicroscopy with +90 diopter volk lens and then assessment of ganglion cell layer inner plexiform layer (GCL-IPL) thickness and retinal nerve fiber layer (RNFL) thickness by using SD OCT Cirrus HD-OCT 5000 (Carl Zeiss Meditec Inc, Dublin, CA, USA).
Then the selected participants were divided into two groups:
group A: involves100 diabetic patients without retinopathy.
group B: involves 100 healthy controls.
The participants were examined for measurement of GCC thickness and showed that there is a statistically significant reduction in the thickness of GCL-IPL and RNFL in diabetic patients when compared with healthy controls, indicating that neurodegeneration occur early in DM.