Çavdarlı Cemal, Büyükyılmaz Gönül, Çavdarlı Büşranur, Çomçalı Sebile, Topçu Yılmaz Pınar, Alp Mehmet Numan
Department of Ophthalmology, Ankara City Hospital, Bilkent, Ankara, 06800, Turkey.
Department of Pediatric Endocrinology, Ankara City Hospital, Bilkent, Ankara, 06800, Turkey.
Acta Diabetol. 2024 Jul;61(7):917-924. doi: 10.1007/s00592-024-02273-6. Epub 2024 Apr 2.
Previous structural, vascular density, and perfusion studies have mostly comprised type 1 and type 2 diabetes, even in the absence of retinopathy. The current study aimed to compare macular vessel density (VD) measurements between maturity-onset diabetes of the young (MODY) patients and controls.
The macular VD of superficial, deep retina, and choriocapillaris (CC), and central macular thickness (CMT), foveal avascular zone (FAZ), FAZ perimetry, VD of the total retina at 300 µm around the FAZ (FD), and acirculatory index (AI) measurements were taken and analyzed via OCT-A (RTVue XR 100-2 Avanti, AngioVue) and were compared between molecularly confirmed MODY (glucokinase (GCK) variants) patients and healthy controls.
Twenty-five MODY patients and 30 healthy controls were included in the study. The mean plasma hemoglobin A1c level in the MODY group was 6.39 ± 0.38. The mean age was 13.8 ± 2.1 in the MODY group and was 12.6 ± 2.5 years among controls. There was no significant difference in terms of the age, superficial and deep retinal VD, FAZ, FAZ perimetry, CMT, FD, or AI between the groups. Compared to the healthy controls, a slight but significant increase in the CC-VD was detected in the MODY group, but only in the parafoveal and perifoveal regions (p = 0.034, p = 0.009).
The significant CC-VD increase in the MODY group might be associated with hyperglycemia and/or relatively poor and vulnerable peripheral vascular CC perfusion compared to the central. Previous thickness and VD results of childhood or adolescent diabetes were distributed in a wider range, suggesting that various factors, including some not yet clearly defined, may affect the choroidal vasculature independently of glycemia or as a contributing factor.
以往的结构、血管密度和灌注研究大多涉及1型和2型糖尿病,即使在没有视网膜病变的情况下也是如此。本研究旨在比较青年成熟期糖尿病(MODY)患者与对照组之间的黄斑血管密度(VD)测量值。
通过光学相干断层扫描血管造影(OCT-A,RTVue XR 100-2 Avanti,AngioVue)测量并分析浅表视网膜、深层视网膜和脉络膜毛细血管(CC)的黄斑VD、中心黄斑厚度(CMT)、黄斑无血管区(FAZ)、FAZ视野检查、FAZ周围300μm处全视网膜的VD(FD)和无循环指数(AI)测量值,并在分子确诊的MODY(葡萄糖激酶(GCK)变异)患者和健康对照之间进行比较。
本研究纳入了25例MODY患者和30例健康对照。MODY组的平均血浆糖化血红蛋白A1c水平为6.39±0.38。MODY组的平均年龄为13.8±2.1岁,对照组为12.6±2.5岁。两组在年龄、浅表和深层视网膜VD、FAZ、FAZ视野检查、CMT、FD或AI方面无显著差异。与健康对照相比,MODY组的CC-VD有轻微但显著的增加,但仅在黄斑旁和黄斑周围区域(p=0.034,p=0.009)。
MODY组CC-VD的显著增加可能与高血糖和/或与中央相比相对较差且易受损的外周血管CC灌注有关。儿童或青少年糖尿病以往的厚度和VD结果分布范围更广,这表明包括一些尚未明确界定的因素在内的各种因素可能独立于血糖或作为一个促成因素影响脉络膜血管系统。