Early microvascular retinal changes in optical coherence tomography angiography in patients with type 1 diabetes mellitus

Simonett, Joseph M.; Scarinci, Fabio; Picconi, Fabiana; Giorno, Paola; Geronimo, Daniele De; Renzo, Antonio Di; Varano, Monica; Frontoni, Simona; Parravano, Mariacristina

doi:10.1111/aos.13404

Cited by 172 publications

(166 citation statements)

References 42 publications

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“…Several studies also suggest that OCTA parameter alterations in the deep vascular layer are affected more severely than in the superficial vascular layer in NPDR [10, 11, 14-16, 17, 21, 23, 26]. OCTA parameters at the deep vascular layer were most significantly affected in patients with DME [4, 29-32].…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Increased FAZ area was present in both superficial and deep vascular layers of patients with NPDR [8, 14, 17-20]. In patients with type 1 diabetes and mild NPDR, vessel density was significantly reduced only in the deep vascular layer compared to control subjects [21]. In mild NPDR, a reduction of the vessel density at the deep vascular layer occurred in earlier stages (mild NPDR) than in the superficial vascular layer [17].…”

Section: Octa Parameters In the Superficial Deep And/or Intermediatmentioning

confidence: 99%

“…In mild NPDR, a reduction of the vessel density at the deep vascular layer occurred in earlier stages (mild NPDR) than in the superficial vascular layer [17]. Vessel density in both superficial and deep vascular layers was significantly decreased in patients with established NPDR [17, 20, 21-25]. A progressive reduction of the deep-vascular-layer vessel density was noted from 25.23% in mild NPDR, 20.16% in moderate NPDR, to 11.16% in severe NPDR [23].…”

Section: Octa Parameters In the Superficial Deep And/or Intermediatmentioning

confidence: 99%

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Implication of Deep-Vascular-Layer Alteration Detected by Optical Coherence Tomography Angiography for the Pathogenesis of Diabetic Retinopathy

Dimitrova¹,

Chihara²

2019

Ophthalmologica

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The aim of this narrative mini review is to analyze optical coherence tomography angiography (OCTA) parameters from reports that involved both superficial and deep vascular layers in patients with diabetes and to assess their relevance for the pathogenesis of diabetic retinopathy (DR). Papers published from January 2015 to August 2018 describing the use of OCTA in diabetes were identified and reviewed through a Medline/PubMed search. OCTA studies suggest that parameters are altered in patients with diabetes in all retinal vascular layers. From all included studies that evaluated both the superficial and the deep vascular layer, a number of studies suggested that the deep vascular layer was affected at an earlier stage of DR. OCTA parameter alterations were more prominent in the deep vascular layer than in the superficial vascular layer in patients with DR, and deep-vascular-layer alterations were most evident in patients with diabetic macular edema. Regarding that retinal venules originate from the deep vascular layer of the retina, alteration of OCTA parameters at the deep vascular layer in diabetic patients may imply a predominant affection of the venous side of the retinal vascular system in the pathogenesis of DR.

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Section: Discussion/conclusionmentioning

confidence: 99%

Section: Octa Parameters In the Superficial Deep And/or Intermediatmentioning

confidence: 99%

Section: Octa Parameters In the Superficial Deep And/or Intermediatmentioning

confidence: 99%

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Implication of Deep-Vascular-Layer Alteration Detected by Optical Coherence Tomography Angiography for the Pathogenesis of Diabetic Retinopathy

Dimitrova¹,

Chihara²

2019

Ophthalmologica

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“…42 The initial lesions along with endothelial proliferation, pericyte damage, and microaneurysms have been identified to be focal and in the posterior pole 59 and are therefore more likely to align with our study results. In addition, a decrease in the density of deep capillary plexus at the macular area has been noted in patients with no or a mild stage of DR. 60 Changes in the capillary plexus and therefore the blood supply and nutrients may affect the normal integrity and/or functioning of the ganglion cells and other neural cells in the retina; these are associated with diabetes-induced accelerated ganglion cell death and likely involve bipolar cells and also photoreceptors. 42 Therefore, the number of fields photographed is less likely to affect our study results.…”

Section: Discussionmentioning

confidence: 99%

Corneal and Retinal Neuronal Degeneration in Early Stages of Diabetic Retinopathy

Srinivasan

Dehghani

Pritchard

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To examine the neuronal structural integrity of cornea and retina as markers for neuronal degeneration in nonproliferative diabetic retinopathy (NPDR).METHODS. Participants were recruited from the broader Brisbane community, Queensland, Australia. Two hundred forty-one participants (187 with diabetes and 54 nondiabetic controls) were examined. Diabetic retinopathy (DR) was graded according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Corneal nerve fiber length (CNFL), corneal nerve branch density (CNBD), corneal nerve fiber tortuosity (CNFT), full retinal thickness, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), focal (FLV) and global loss volumes (GLV), hemoglobin A 1c (HbA 1c ), nephropathy, neuropathy, and cardiovascular measures were examined.RESULTS. The central zone (P ¼ 0.174), parafoveal thickness (P ¼ 0.090), perifovea (P ¼ 0.592), RNFL (P ¼ 0.866), GCC (P ¼ 0.798), and GCC GLV (P ¼ 0.338) did not differ significantly between the groups. In comparison to the control group, those with very mild NPDR and those with mild NPDR had significantly higher focal loss in GCC volume (P ¼ 0.036). CNFL was significantly lower in those with mild NPDR (P ¼ 0.004) in comparison to the control group and those with no DR. The CNBD (P ¼ 0.094) and CNFT (P ¼ 0.458) did not differ between the groups.CONCLUSIONS. Both corneal and retinal neuronal degeneration may occur in early stages of diabetic retinopathy. Further studies are required to examine these potential markers for neuronal degeneration in the absence of clinical signs of DR.

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“…In addition, there is evidence that capillary rarefaction starts in the deep capillary plexus [20,25]. Moreover, Agemy et al [24] reported that the loss of capillary density was greater in the superficial capillary plexus than in the deep capillary plexus.…”

Section: Discussionmentioning

confidence: 99%

The Relationship between Macular Pigment and Vessel Density in Patients with Type 1 Diabetes Mellitus

et al. 2018

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Aim: Macular pigment density and microvascular density on optical coherence tomography angiography (OCTA) were measured in a cohort of type 1 diabetes mellitus (T1DM) patients with retinopathy in the attempt to shed light on the pathophysiology of this condition. Methods: Eighty-two consecutive eyes of 59 patients with diabetic retinopathy examined at the Eye Clinic of the University of Naples Federico II from November 2016 to April 2017 were enrolled in this prospective study. Eighty normal eyes of 40 age-matched subjects without diabetes mellitus, without a history of glaucoma or evidence of intraocular surgery, and without retinal pathologic features constituted the control group. All patients and controls underwent a complete ophthalmic examination, best corrected visual acuity evaluation according to the ETDRS visual logMAR scale, measurement of intraocular pressure, OCTA, and evaluation of macular pigment. Results: There were no significant age differences between patients and controls. Both macular pigment measurements and vessel density measured by OCTA were significantly lower in patients than in controls. A moderate correlation was found between vessel density in all ETDRS sectors and macular pigment parameters. Conclusions: There was a reduction in macular pigment and in OCTA vessel density in T1DM patients with retinopathy, which may have prognostic value in determining disease progression.

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Early microvascular retinal changes in optical coherence tomography angiography in patients with type 1 diabetes mellitus

Cited by 172 publications

References 42 publications

Implication of Deep-Vascular-Layer Alteration Detected by Optical Coherence Tomography Angiography for the Pathogenesis of Diabetic Retinopathy

Implication of Deep-Vascular-Layer Alteration Detected by Optical Coherence Tomography Angiography for the Pathogenesis of Diabetic Retinopathy

Corneal and Retinal Neuronal Degeneration in Early Stages of Diabetic Retinopathy

The Relationship between Macular Pigment and Vessel Density in Patients with Type 1 Diabetes Mellitus

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