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Marcus Werner Storch,1 Greta Zinser,1 Peer Lauermann,1 Mohammed Haitham Khattab,1 Anna Nguyen-Höhl,1 Dirk Raddatz,2 Katja Gollisch,2 Josep Callizo,1 Hans Hoerauf,1 Nicolas Feltgen1 1Department of Ophthalmology, University of Göttingen, Göttingen, Niedersachsen, Germany; 2Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University of Göttingen, Göttingen, Niedersachsen, GermanyCorrespondence: Marcus Werner Storch, Department of Ophthalmology, University of Göttingen, Robert-Koch-Str. 40, Göttingen, 37075, Germany, Tel +49-551-39-63580, Fax +49-551-39-63582, Email marcus.storch86@googlemail.comPurpose: To correlate functional and morphological parameters with foveal avascular zone’s (FAZ) size in diabetic patients with mild to moderate stage nonproliferative diabetic retinopathy.Methods: Monocentric and prospective study of a consecutive case series of diabetic patients. Medical history, best corrected visual acuity (BCVA), best corrected high/low contrast visual acuity (BChcVA/BClcVA), mean sensitivity (MS) and mean defect (MD) in central visual field testing, and FAZ size in fluorescein-angiography (FAG) were recorded. Macular thickness (central point thickness CPT, central subfield thickness CST) and volume measurements (central subfield volume CSV, total macular volume) were taken from SD-OCT (6x6mm ETDRS-grid). Groups were categorised as presenting FAZ sizes smaller (G1) or larger (G2) than 0.35mm2. Smallest (Q1) and largest quartiles (Q3) were also compared.Results: Thirty-six of 40 patients were included. MS differed significantly between G1 (n = 6) and G2 (n = 30), and BChcVA/BClcVA as well as TMV correlated significantly with FAZ size in correlation analysis. Mean HbA1c tended to be lower in G1 than G2. Patients in G1 were slightly older than in G2. Treatment period with insulin was shorter in G1/Q1 than in G2/Q3. CPT and TMV were lower in G1/Q1 than in G2/Q3. Our analysis of the FAZ in terms of patient age, HbA1c, disease duration and insulin therapy duration revealed no significance. That lack of significance also applies to BCVA, MS, MD, CPT, CST and CSV.Conclusion: As significantly associated, contrast sensitivity, central visual field parameters and potentially retinal thickness or volume seem to be suitable to detect early macular ischaemia. However, we failed to establish any correlation between FAZ and BCVA.Keywords: foveal avascular zone, contrast vision, visual acuity, fluorescein angiography, diabetic retinopathy, ischemia

Many obese people with type 2 diabetes develop non-alcoholic fatty liver disease, which may progress to liver fibrosis. EndoBarrier gastrointestinal liner is an innovative interventional treatment option for type 2 diabetic patients, which could affect diabetes associated liver disease. The aim of this retrospective study was to analyze the effect of 1-year EndoBarrier therapy on liver fibrosis and steatosis. As an indicator of fibrosis, liver stiffness was assessed by liver elastography at baseline, 2 weeks after EndoBarrier implantation and then every 3 months until explantation. 13/19 patients had elevated liver stiffness at baseline, corresponding to liver fibrosis grade 2 to 4. In these patients, liver stiffness reduced significantly during EndoBarrier therapy from 10.4 kPa (IQR 6.0-14.3) at baseline to 5.3 kPa (IQR 4.3-7.7, p < 0.01) by the time of EndoBarrier explantation, corresponding to a normalization of the initially pathologic findings in most patients. Liver steatosis was also assessed by elastographic measurements in terms of the controlled attenuation parameter. In all patients, baseline measurements showed high grade steatosis. Improvements were seen from initially 343 dB/m (IQR 326-384) to 317 dB/m (IQR 269-375, p < 0.05) by the time of explantation. However, most patients were still classified high grade steatosis after completion of EndoBarrier treatment. In this observational study, we show that liver fibrosis is a common condition in obese patients suffering from type 2 diabetes, and that EndoBarrier gastrointestinal liner substantially improves liver fibrosis in these patients. [ABSTRACT FROM AUTHOR]