Abstract: Objective  To investigate the brain damage in patients with diabetic retinopathy (DR). Methods  Twenty-seven type 2 diabetes mellitus (T2DM) patients with retinopathy (DM group) and twenty-four healthy controls (HC group) were selected. Proton magnetic resonance spectroscopy (1H-MRS) and diffusion-weighted imaging (DWI) were performed on all the participants. Regions of interest (ROIs) were located in the left frontal white matter, left lenticular nucleus, and left optic radiation. N-acetylaspartate (NAA)/creatine (Cr), Choline (Cho)/creatine (Cr), myo-inositol (MI)/Cr, and NAA/Cho ratios and ADC values of all the ROIs were obtained. Results  In the frontal white matter, NAA/Cr and NAA/Cho ratios were lower in the DM group than in the HC group (P<0.05). In the lenticular nucleus, NAA/Cr ratios were lower in the DM group than in the HC group (P<0.05). In the optic radiation, NAA/Cho ratios in the DM group were decreased, while MI/Cr values were increased compared with those in the HC group (P<0.05). In the DM group,  NAA/Cr ratios in the frontal white matter were negatively correlated with glycosylated hemoglobin (HbA1C) levels (r=-0.652,  P<0.05). In the optic radiation,  MI/Cr ratios were positively correlated with Cho/Cr values (r=0.520, P<0.05) in the DM group. ADC values in the DM group were significantly higher than those in the HC group (P<0.05). Conclusion  Patients with DR are accompanied with early brain injury and clinicians should take measures to prevent the occurrence of severe cerebrovascular diseases.

Key words: Brain damage, Magnetic resonance spectroscopy, Diffusion-weighted imaging, Diabetic retinopathy