الفهرس 
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Abstract
Diabetic retinopathy (DR) is the most common complication of diabetes. DR is now considered a more complex diabetic complication in which neurodegeneration plays a significant role with microvascular changes.
The main aim of the study was to assess ganglion cell complex thickness in type-2 diabetic patients with early non-proliferative diabetic retinopathy without macular edema and to compare them with normal control subjects of the same age group using spectral domain optical coherence tomography.
The structure of the neuronal retinal layers (RNFL and GCC) was affected early by diabetes, which even preceded the retinal vascular changes and visual affections in occurrence in most of the studied patients. There was a statistically significant correlation between the thinning of most of the GCC quadrants and uncontrolled glucose and higher HbA1c levels.
This cross-sectional study was performed on 150 eyes divided into two groups: group 1: 100 eyes of diabetic patients diagnosed with early (mild) non-proliferative diabetic retinopathy without macular edema who attended to the outpatient eye clinic at Menofia University Hospital. group 2: included a group of (50) non-diabetic control individuals of the same age group as the diabetic group and with no other systemic diseases.
Functional and anatomical alterations are observed in diabetic patients with mild DR, suggesting that DM leads to deterioration in retinal sensitivity and inner retinal layer thickness, even though the vascular lesions are mild and there is no macular edema.
Analysis of the retinal layers by OCT offers an opportunity for early detection of neuronal damage secondary to this pathology, providing the possibility for an early diagnosis and an improved prognosis.
It is recommended to use GCC thickness as an early warning marker of retinopathy development by doing routine nerve fibre scan with the routinely requested macular OCT in the diabetic ocular checkup and in the monitoring of newly diagnosed cases of DM.
It should also not be neglected during the follow-up of diabetic patients on antihyperglycemic treatment with highly suspected DR or vasculopathy.
Moreover, in uncontrolled diabetes with higher HbA1C levels, we found it urgent for the diabetic patient’s ophthalmologist and internist to continuously coordinate and share data for appropriate intervention and management.