Comparative study between patients with subclinical diabetic retinopathy and healthy individuals in the retinal microvascular changes using optical coherence tomography angiography

Eldin, Abd Elmagid M Tag

doi:10.4103/djo.djo_8_19

Cited by 3 publications

(1 citation statement)

References 2 publications

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“…Some studies documented the reduction of perfusion density only in patients with DR, with no significant changes between non-diabetic and diabetic subjects without DR [ 26 , 27 ]. In contrast, other studies showed a considerable decrease in the perfusion density in patients with diabetes without clinical manifestations of DR [ 27 – 29 ]. Only a few studies have been conducted on subjects with prediabetes.…”

Section: Discussionmentioning

confidence: 81%

Assessment of early macular microangiopathy in subjects with prediabetes using optical coherence tomography angiography and fundus photography

El Sawy,

Bekhit,

Abdelhamid

et al. 2023

Acta Diabetol

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Aims Early detection of retinal microangiopathy in patients with prediabetes may reduce diabetic retinopathy complications. The aim of this study was to assess early macular vascular changes in prediabetics before development of over diabetes using OCTA and fundus photography. Methods In this cross-sectional study, 66 prediabetic individuals and 66 normal controls underwent clinical, laboratory, and fundus photography evaluation followed by OCTA macular imaging to examine for the foveal avascular zone, and area of capillary non-perfusion, thickness, disorganization of vessels, and vessel density perfusion percentage of superficial capillary plexus and deep capillary plexus. Results Retinal microangiopathy was detected in 36.4% of prediabetics by OCTA and only in 10.6% by fundus photography. None of clinical or laboratory parameters had significant association with DR. Area of capillary non-perfusion and disorganization of SCP were detected in 53.8% and 56.8%, respectively, in prediabetics. VDP of SCP and DCP of whole image, parafoveal, and perifoveal areas was significantly lower in prediabetes group compared to normal control. VDP of DCP of perifoveal area (β coefficient: − 0.10, OR: 0.91, 95% CI: 0.86–0.96, P < 0.001) and disorganization of DCP (β coefficient: 1.93, OR: 6.89, 95% CI: 2.5–18.8, P < 0.001) were significant predictors of DR in prediabetics. There was no difference in FAZ in prediabetics with and without retinopathy. Conclusions OCTA could detect early retinal vascular changes during the prediabetic state before developing diabetes. VDP was significantly reduced in prediabetic patients. Furthermore, VDP of DCP of perifoveal area and disorganization of DCP were the most important predictors of retinopathy in prediabetic patients.

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Section: Discussionmentioning

confidence: 81%

Assessment of early macular microangiopathy in subjects with prediabetes using optical coherence tomography angiography and fundus photography

El Sawy,

Bekhit,

Abdelhamid

et al. 2023

Acta Diabetol

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Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography

et al. 2021

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Background: Timely detection of early microvascular changes in patients with prediabetes could help reduce the likelihood of progression of diabetes-related retinal complications. Aim: To determine early microvascular changes in patients with prediabetes using optical coherence tomography angiography (OCT-A). Methods: In this single-center retrospective case-control study, macular OCT-A images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed in non-diabetic controls, and prediabetic and diabetic subjects. A quantitative analysis was performed using ImageJ software of the foveal avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD), and vascular length density (VLD). Results: A total of 94 eyes of 53 patients were included in this study. The global mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, the mean PD was 0.283 ± 0.15, 0.186 ± 0.720, and 0.186 ± 0.07 in non-diabetic controls, and prediabetic and diabetic groups, respectively. The mean VLD was 8.728 ± 3.425 in non-diabetic controls, 6.147 ± 1.399 in prediabetic group, and 6.292 ± 1.997 in patients with diabetes. The comparison of prediabetic patients and controls shows statistical differences between PD and VLD in both plexus SCP ( p = 0.002 and p = 0.001, respectively) and DCP ( p = 0.005 and p = 0.002, respectively). The mean area of FAZ in patients with diabetes and normal individuals was 0.281 and 0.196 mm2, respectively ( p < 0.001). AI was higher in the control group (0.87 ± 0.14) and prediabetic group (0.80 ± 0.17) compared to diabetic patients (0.64 ± 0.19). There were no differences in FAZ area and AI between prediabetic and non-diabetic controls. Conclusion: PD and VLD demonstrated to be early microvascular changes in prediabetic patients evaluated by OCT-A. No alterations of FAZ were evidenced in this group.

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Macular and choroidal perfusion using optical coherence tomography angiography in type-2 diabetic patients without diabetic retinopathy

ElShazly

Sabbah

Hamza

et al. 2022

Delta Journal of Ophthalmology

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Purpose The aim of this study was to evaluate the changes in retinal vascular plexuses and choriocapillaris in type-2 diabetes mellitus (DM) patients without clinical diabetic retinopathy (DR) and to compare them with healthy controls and to identify early preclinical biomarkers for DR using optical coherence tomography angiography (OCTA). Patients and methods This is a prospective cross-sectional study that included 68 eyes (34 eyes of type-2 diabetic patients without DR and 34 eyes of healthy controls). Using OCTA, the vessel density (VD) in the superficial and deep capillary plexuses, macular thickness, foveal avascular zone (FAZ) area, and choriocapillaris flow area were measured. The OCTA morphological findings in diabetic patients were noted. In addition, the correlations between OCTA and glycosylated hemoglobin and diabetes duration were evaluated. Results There was a statistically significant decrease in the parafoveal macular thickness in the diabetic group compared with the control group (the superior–hemi parafoveal thickness was 310.94±10.84 vs. 321.71±11.2 μm, respectively, P=0.001, while the inferior–hemi parafoveal thickness was 304.71±11.04 vs. 320.82±11.25 μm, respectively, P=0.001). There was no statistically significant difference in the parafoveal and perifoveal superficial capillary plexus and DCP VD in the diabetic patients compared with the controls. In addition, there was no change in the FAZ area between the two groups, but there was a significant difference regarding the FAZ irregularity (P=0.00). Microaneurysms (100%), capillary nonperfusion (94%), capillary loop (17.6%), enlarged perifoveal intercapillary spaces (17.6%), punched-out FAZ (12%), lost spider web (6%), and capillary blind end (6%) were detected in the diabetic patients. A negative significant correlation was found between the parafoveal thickness and glycosylated hemoglobin in the DM group in the inferior–hemi thickness (r=−0.61, P=0.01), and between DM duration and VD in the DCP in the parafoveal and perifoveal areas (r=−0.55, P=0.06 and r=0.62, P=0.018, respectively). Conclusion OCTA can be used to diagnose preclinical maculopathy/retinopathy in diabetic patients using the parafoveal retinal thickness, DCP VD, FAZ irregularities, quantification of microaneurysms, and choriocapillaris flow area as biomarkers.

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Comparative study between patients with subclinical diabetic retinopathy and healthy individuals in the retinal microvascular changes using optical coherence tomography angiography

Cited by 3 publications

References 2 publications

Assessment of early macular microangiopathy in subjects with prediabetes using optical coherence tomography angiography and fundus photography

Assessment of early macular microangiopathy in subjects with prediabetes using optical coherence tomography angiography and fundus photography

Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography

Macular and choroidal perfusion using optical coherence tomography angiography in type-2 diabetic patients without diabetic retinopathy

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