Emre Sinan, Altin Cihan, Ulusoy Mahmut Oguz, Aydin Elcin
Department of Ophthalmology, School of Medicine, Baskent University, Izmir, Turkey.
Department of Cardiology, School of Medicine, Baskent University, Izmir, Turkey.
Oman J Ophthalmol. 2024 Feb 21;17(1):96-101. doi: 10.4103/ojo.ojo_197_22. eCollection 2024 Jan-Apr.
The purpose of this study was to evaluate prediabetic patients for microvascular changes using optical coherence tomography-angiography (OCT-A) and compare with diabetic patients and healthy controls.
OCT-A images of 60 eyes of 30 patients with diabetes mellitus (DM), 72 eyes of 36 prediabetic patients, and 108 eyes of 54 healthy controls were retrospectively evaluated and compared in this study. A swept-source OCTA (Triton, Topcon) instrument was used for collecting OCT-A images. Duration of the diabetic or prediabetic period, glycated hemoglobin, fasting blood glucose level, postprandial glucose (PPG) level, high-density lipoprotein, low-density lipoprotein, triglyceride, and creatinine values of all participants were recorded.
Microaneurysm, nonperfusion areas, perifoveal capillary disruption, and capillary network disorganization were detected in both prediabetics and diabetics but statistically more common in diabetic patients. Neovascularization and intraretinal microvascular anomalies were detected only in diabetic patients.
OCT-A seemed to be effective in detecting microvascular changes in diabetic patients. More importantly, results showed us that in prediabetic patients, microvascular changes can be seen before the onset of DM and before or concurrently with neurodegenerative changes.
本研究旨在使用光学相干断层扫描血管造影（OCT-A）评估糖尿病前期患者的微血管变化，并与糖尿病患者和健康对照进行比较。
本研究回顾性评估并比较了30例糖尿病（DM）患者的60只眼、36例糖尿病前期患者的72只眼和54例健康对照的108只眼的OCT-A图像。使用扫频源OCTA（Triton，拓普康）仪器采集OCT-A图像。记录所有参与者的糖尿病或糖尿病前期病程、糖化血红蛋白、空腹血糖水平、餐后血糖（PPG）水平、高密度脂蛋白、低密度脂蛋白、甘油三酯和肌酐值。
在糖尿病前期患者和糖尿病患者中均检测到微动脉瘤、无灌注区、黄斑中心凹周围毛细血管破坏和毛细血管网络紊乱，但在糖尿病患者中在统计学上更为常见。仅在糖尿病患者中检测到新生血管形成和视网膜内微血管异常。
OCT-A似乎在检测糖尿病患者的微血管变化方面有效。更重要的是，结果表明，在糖尿病前期患者中，微血管变化可在糖尿病发病前以及神经退行性变化之前或同时出现。
