Merve Inanc1, Kemal Tekin2, Hasan Kiziltoprak3, Servan Ozalkak4, Sibel Doguizi3, Zehra Aycan4. 1. Ophthalmology Department, Ercis State Hospital, Van, Turkey; Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey. Electronic address: mrvn888@gmail.com. 2. Ophthalmology Department, Ercis State Hospital, Van, Turkey; Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey. 3. Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey. 4. Department of Pediatric Endocrinology, Dr Sami Ulus Children's Health and Disease Training and Research Hospital, Ankara, Turkey.
Abstract
PURPOSE: To investigate whether abnormal glucose metabolism in diabetes mellitus (DM) affects the retinal microcirculation of children with well-controlled type 1 DM and to compare these results with those obtained from healthy children. DESIGN: Cross-sectional prospective study. METHODS: This study enrolled 60 patients with DM without clinically detectable diabetic retinopathy (DR) and 57 age-matched control subjects. Optical coherence tomography angiography (OCT-A) was performed using AngioVue (Avanti, Optivue). Foveal avascular zone (FAZ) area, nonflow area, superficial and deep vessel densities, FAZ perimeter, acircularity index of FAZ (AI; the ratio of the perimeter of FAZ and the perimeter of a circle with equal area), and foveal density (FD-300; vessel density in 300 μm around FAZ) were analyzed. Correlations between the investigated OCT-A parameters with DM duration and glycated hemoglobin (HbA1c) levels were evaluated among patients with type 1 DM. RESULTS: Differences in the mean values for FAZ perimeter, AI, and FD-300 were statistically significant between DM group and control group (P < .001, P = .001, and P = .009, respectively). There were also statistically significant differences between the groups for vessel densities of deep superior hemi-parafovea, deep temporal parafovea, and deep superior parafoveal zones (P = .008, P = .015, and P = .005, respectively). There were no significant correlations between DM duration and HbA1c levels with the investigated OCT-A parameters. CONCLUSION: Diabetic eyes without clinically detectable DR exhibited alterations in FD-300, AI, perimeter, and vessel density of parafoveal capillaries in deep capillary plexus preceding the enlargement of FAZ; therefore, these new parameters might be sensitive imaging biomarkers to define early DR.
PURPOSE: To investigate whether abnormal glucose metabolism in diabetes mellitus (DM) affects the retinal microcirculation of children with well-controlled type 1 DM and to compare these results with those obtained from healthy children. DESIGN: Cross-sectional prospective study. METHODS: This study enrolled 60 patients with DM without clinically detectable diabetic retinopathy (DR) and 57 age-matched control subjects. Optical coherence tomography angiography (OCT-A) was performed using AngioVue (Avanti, Optivue). Foveal avascular zone (FAZ) area, nonflow area, superficial and deep vessel densities, FAZ perimeter, acircularity index of FAZ (AI; the ratio of the perimeter of FAZ and the perimeter of a circle with equal area), and foveal density (FD-300; vessel density in 300 μm around FAZ) were analyzed. Correlations between the investigated OCT-A parameters with DM duration and glycated hemoglobin (HbA1c) levels were evaluated among patients with type 1 DM. RESULTS: Differences in the mean values for FAZ perimeter, AI, and FD-300 were statistically significant between DM group and control group (P < .001, P = .001, and P = .009, respectively). There were also statistically significant differences between the groups for vessel densities of deep superior hemi-parafovea, deep temporal parafovea, and deep superior parafoveal zones (P = .008, P = .015, and P = .005, respectively). There were no significant correlations between DM duration and HbA1c levels with the investigated OCT-A parameters. CONCLUSION:Diabetic eyes without clinically detectable DR exhibited alterations in FD-300, AI, perimeter, and vessel density of parafoveal capillaries in deep capillary plexus preceding the enlargement of FAZ; therefore, these new parameters might be sensitive imaging biomarkers to define early DR.
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