Microvascular retinal changes in pre-clinical diabetic retinopathy as detected by optical coherence tomographic angiography.

Abstract

PURPOSE:

To investigate microvascular abnormalities in diabetic patients without conventional clinical signs of diabetic retinopathy (DR).

METHODS:

In this cross-sectional observational cohort study, the study group included randomly chosen participants of a community-based cohort with diabetes type 2 without DR, and the control group consisted of non-diabetic individuals from a population-based study. All participants underwent optical coherence tomographic angiography (OCTA).

RESULTS:

Upon OCTA, 118 (40.4%) eyes of the study group (n = 292 eyes) showed microvascular abnormalities including foveal avascular zone erosion (95 (32.5%) eyes), non-perfusion areas in the superficial and deep retinal layers (39 (13.4%) eyes and 19 (6.5%) eyes, respectively), and microaneurysms in the superficial and deep retinal layers (22 (7.5%) eyes and 31 (10.6%) eyes, resp.). None of these abnormalities was detected in the control group (n = 80). The study group showed a lower vessel density in the superficial retinal vascular layer in all regions except for the foveal region (P < 0.001), and higher vessel density in the parafoveal region in the deep retinal vascular layer (P = 0.01). Higher diabetes prevalence was associated with lower superficial retinal vascular density (P = 0.005) in multivariable analysis. A lower radial peripapillary capillary flow density was correlated (regression coefficient r, 0.62) with higher fasting blood concentration of glucose (P < 0.001) in multivariable analysis.

CONCLUSIONS:

OCTA revealed microvascular abnormalities in 40% of eyes of diabetic patients without ophthalmoscopically detectable diabetic fundus changes in a community-based population. The early stage of DR may be re-defined upon OCTA.

• Authors: Jing Yan Yang, Qian Wang, Yan Ni Yan, Wen Jia Zhou, Ya Xing Wang, Shou Ling Wu, Ming Xia Yuan, Wen Bin Wei, Jost B Jonas
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 258 Issue 3 Pg. 513-520 (Mar 2020) ISSN: 1435-702X [Electronic] Germany
• PMID: 31897704 (Publication Type: Journal Article, Multicenter Study, Observational Study)

Topics

• Aged
• Capillaries (pathology)
• Cross-Sectional Studies
• Diabetic Retinopathy (diagnosis)
• Female
• Fluorescein Angiography (methods)
• Fovea Centralis (blood supply, pathology)
• Fundus Oculi
• Humans
• Male
• Retinal Vessels (pathology)
• Retrospective Studies
• Tomography, Optical Coherence (methods)