Lv Bing-Jing, Zuo Hang-Jia, Li Qi-Fu, Huang Fan-Fan, Zhang Tong, Huang Rong-Xi, Zheng Shi-Jie, Wan Wen-Juan, Hu Ke
Chongqing Medical University, Chongqing 400000, China.
Department of Ophthalmology, Dianjiang People's Hospital of Chongqing, Chongqing 4008300, Chongqing, China.
World J Radiol. 2024 Sep 28;16(9):407-417. doi: 10.4329/wjr.v16.i9.407.
Retinal microcirculation alterations are early indicators of diabetic microvascular complications. Optical coherence tomography angiography (OCTA) is a noninvasive method to assess these changes. This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.
To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.
Fifty volunteers were divided into three groups: Group 1 [impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)], Group 2 (both IFG and IGT), and a control group. Retinal microcirculation parameters, including vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) metrics, were measured using OCTA. Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.
One hour after glucose intake, the central VD ( = 0.023), central PD ( = 0.026), and parafoveal PD ( < 0.001) were significantly greater in the control group than in the fasting group. In Group 1, parafoveal PD ( < 0.001) and FAZ circularity ( = 0.023) also increased one hour after glucose intake. However, no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake ( > 0.05). Compared with the control group, Group 1 had a larger FAZ area ( = 0.032) and perimeter ( = 0.018), whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group ( > 0.05). Compared with Group 1, Group 2 had greater central VD ( = 0.013) and PD ( = 0.008) and a smaller FAZ area ( = 0.012) and perimeter ( = 0.010). One hour after glucose intake, Group 1 had a larger FAZ area ( = 0.044) and perimeter ( = 0.038) than did the control group, whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group ( > 0.05). Group 2 had greater central VD ( = 0.042) and PD ( = 0.022) and a smaller FAZ area ( = 0.015) and perimeter ( = 0.016) than Group 1. At fasting, central PD was significantly positively correlated with blood glucose levels ( = 0.044), whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.
A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.
视网膜微循环改变是糖尿病微血管并发症的早期指标。光学相干断层扫描血管造影（OCTA）是评估这些变化的一种非侵入性方法。本研究使用OCTA分析糖尿病前期患者在短期血糖升高期间视网膜微循环的变化。
使用OCTA研究血糖水平短期升高的糖尿病前期患者视网膜微循环的变化。
50名志愿者被分为三组：第1组[空腹血糖受损（IFG）或糖耐量受损（IGT）]，第2组（IFG和IGT均有），以及一个对照组。使用OCTA测量视网膜微循环参数，包括血管密度（VD）、灌注密度（PD）和黄斑无血管区（FAZ）指标。在空腹和餐后状态下分析这些参数与血糖水平之间的相关性。
摄入葡萄糖1小时后，对照组的中心VD（=0.023）、中心PD（=0.026）和黄斑旁PD（<0.001）显著高于空腹组。在第1组中，摄入葡萄糖1小时后黄斑旁PD（<0.001）和FAZ圆形度（=0.023）也增加。然而，第2组在摄入葡萄糖前后视网膜微循环参数均未观察到显著变化（>0.05）。与对照组相比，第1组的FAZ面积（=0.032）和周长（=0.018）更大，而第2组与对照组相比视网膜微循环参数无显著差异（>0.05）。与第1组相比，第2组的中心VD（=0.013）和PD（=0.008）更大，FAZ面积（=0.012）和周长（=0.010）更小。摄入葡萄糖1小时后，第1组的FAZ面积（=0.044）和周长（=0.038）大于对照组，而第2组与对照组相比视网膜微循环参数无显著差异（>0.05）。第2组的中心VD（=0.042）和PD（=0.022）大于第1组，FAZ面积（=0.015）和周长（=0.016）小于第1组。在空腹时，中心PD与血糖水平显著正相关（=0.044），而摄入葡萄糖1小时后血糖水平与OCTA参数之间未发现显著相关性。
血糖短期升高对患有IFG或IGT的糖尿病前期患者的视网膜微循环有更明显的影响。
