Sustained Benefit of Short-Term Levodopa Treatment on Inner Retinal Function in Patients With Diabetes.

Purpose: This study investigated the long-term progression of oscillatory potential (OP) implicit times (ITs) in individuals with preclinical diabetic retinopathy (DR) with and without levodopa (L-DOPA) treatment by quantifying functional and structural retinal changes.

Methods: Participants from the Motz et al. (2020) study were re-evaluated after 5 years, including individuals with diabetes mellitus (DM) who received L-DOPA treatment for 2 weeks (the DM + L-DOPA group; n = 14), those who did not (the DM group; n = 6), and non-diabetic healthy controls (the control group; n = 37). Retinal function and structure were assessed using dim-flash electroretinography (ERG) and optical coherence tomography (OCT).

Results: After 5 years, OP 1 and OP 2 ITs showed no significant differences among the groups (P > 0.05). The DM + L-DOPA OP IT values remained improved compared to baseline. The outer region thickness of the outer plexus layer (OPL) and ganglion cell layer (GCL) were significantly thinner in the DM + L-DOPA group compared to the DM group (P < 0.05). The DM group showed strong correlations between OP IT and OCT thickness across all retinal regions, whereas the DM + L-DOPA group correlations were similar to the control group.

Conclusions: Short-term L-DOPA treatment led to significant functional improvements after 2 weeks, with trends suggesting sustained benefit over 5 years. Inner retinal structural differences suggest potential long-term benefit of L-DOPA on retinal health. These findings support OP IT delays as early biomarkers for preclinical DR and suggest L-DOPA may provide lasting neuroprotective benefits.

Translational Relevance: Retinal dysfunction and inner retinal structural changes could be potential biomarkers for preclinical DR, and L-DOPA treatment may provide sustained benefits for the diabetic retina.