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Invest Ophthalmol Vis Sci. 2020 Mar 9;61(3):4. doi: 10.1167/iovs.61.3.4.
To investigate the clinical significance of the changes in the macular microvasculature in patients with diabetes mellitus type 2 without diabetic retinopathy.
Fifty-five patients with diabetes mellitus type 2 without diabetic retinopathy and 48 healthy individuals were enrolled in a prospective cross-sectional study. We identified the changes of optical coherence tomography angiography parameters (foveal avascular zone [FAZ] area and circularity, vessel density, and perfusion index) of the 6 × 6-mm macular scan. Correlation and multiple regression analyses were performed between optical coherence tomography angiography parameters and previously known diabetes mellitus type 2-related demographic and systemic characteristics, and serum biochemical markers.
FAZ parameters and perfusion index of the superficial and deep vascular plexus showed significant correlation with serum insulin level, and homeostasis model assessment indices. In multiple linear regression analysis, low insulin levels predicted increased FAZ areas in both the superficial (β = -0.007; P = 0.030) and deep layers (β = -0.010; P = 0.018) and a decreased perfusion index in the deep layer (β = 0.003; P = 0.001).
The expansion and loss of circularity of the FAZ and the decrease in the perfusion index may be affected by insulin resistance and secretory capacity in patients with diabetes mellitus type 2 with no diabetic retinopathy.
探讨 2 型糖尿病无糖尿病视网膜病变患者黄斑微血管变化的临床意义。
前瞻性横断面研究纳入了 55 例 2 型糖尿病无糖尿病视网膜病变患者和 48 名健康个体。我们确定了 6×6mm 黄斑扫描的光学相干断层血管造影参数（中心凹无血管区[FAZ]面积和圆度、血管密度和灌注指数）的变化。对光学相干断层血管造影参数与先前已知的 2 型糖尿病相关的人口统计学和全身特征以及血清生化标志物进行了相关性和多元回归分析。
FAZ 参数和浅层及深层血管丛的灌注指数与血清胰岛素水平和稳态模型评估指数呈显著相关。在多元线性回归分析中，低胰岛素水平预测浅层（β=-0.007；P=0.030）和深层（β=-0.010；P=0.018）FAZ 面积增大，深层灌注指数降低（β=0.003；P=0.001）。
在无糖尿病视网膜病变的 2 型糖尿病患者中，FAZ 的扩大和圆度丧失以及灌注指数降低可能受胰岛素抵抗和分泌能力的影响。
