Biomedical, Dental and Morphological and Functional Images Sciences, Department of Ophthalmology, University of Messina, 98122, Messina, Italy.
Glangwili General Hospital Carmarthen, Carmarthen, SA31 2AF, Wales, UK.
Int Ophthalmol. 2021 Feb;41(2):649-658. doi: 10.1007/s10792-020-01621-z. Epub 2020 Nov 6.
To analyze the early macular microvascular alterations in patients with type 1 and 2 diabetes mellitus (DM) without diabetic retinopathy (DR), using optical coherence tomography angiography (OCT-A), and compare these with nondiabetic patients.
This prospective study involved 93 patients with type 1 diabetes (DM1), 104 patients with type 2 diabetes (DM2) without signs of DR, and 71 healthy subjects for the control group. The foveal avascular zone (FAZ) area and the vessel density (VD) at the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were evaluated.
The SCP and DCP FAZ areas were significantly larger in the DM1 group in comparison with the controls (p = .001), while no significant differences were observed between the DM2 group and the healthy control group (p = .12). Additionally, no significant differences in FAZ area were found between the DM1 and DM2 groups (p = .26). The VD was significantly reduced in DM1 and DM2 groups compared to controls. A direct correlation was found between the duration of diabetes and SCP FAZ area (r = 0.44; R = 0.19; p = .0001). Statistically significant differences in the FAZ area at SCP and DCP were observed when comparing patients with a diabetes duration > 10 years and < 10 years in the DM2 group (p = .0001, respectively) and only in the FAZ area at the DCP in the DM1 group (p = .0001).
Diabetic patients without DR demonstrate early microvascular alteration in the macular area on OCT-A, which is more pronounced in type I DM, and correlates with the duration of the disease.
使用光相干断层扫描血管造影术（OCT-A）分析无糖尿病视网膜病变（DR）的 1 型和 2 型糖尿病（DM）患者的早期黄斑微血管改变，并与非糖尿病患者进行比较。
这项前瞻性研究纳入了 93 例 1 型糖尿病（DM1）患者、104 例 2 型糖尿病（DM2）患者（无 DR 迹象）和 71 例健康对照者。评估了黄斑中心凹无血管区（FAZ）面积和浅层毛细血管丛（SCP）和深层毛细血管丛（DCP）的血管密度（VD）。
与对照组相比，DM1 组的 SCP 和 DCP FAZ 区域明显更大（p = .001），而 DM2 组与健康对照组之间无显著差异（p = .12）。此外，DM1 和 DM2 组之间 FAZ 区域无显著差异（p = .26）。与对照组相比，DM1 和 DM2 组的 VD 明显降低。DM1 和 DM2 组的糖尿病病程与 SCP FAZ 区域之间存在直接相关性（r = 0.44；R = 0.19；p = .0001）。DM2 组中糖尿病病程>10 年和<10 年的患者之间，SCP 和 DCP 的 FAZ 区域有显著差异（p = .0001，分别），而在 DM1 组中仅在 DCP 的 FAZ 区域有显著差异（p = .0001）。
无 DR 的糖尿病患者在 OCT-A 上显示出黄斑区的早期微血管改变，在 1 型 DM 中更为明显，并且与疾病持续时间相关。
