Małyszczak Artur, Przeździecka-Dołyk Joanna Wiktoria, Szydełko-Paśko Urszula, Misiuk-Hojło Marta
Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland.
Ophthalmology Clinical Center SPEKTRUM, Research and Development Center CREO, Wroclaw, Dolnoslaskie, Poland.
Clin Ophthalmol. 2024 Oct 25;18:3019-3029. doi: 10.2147/OPTH.S480207. eCollection 2024.
The purpose of this study was to evaluate retinal and choroidal vascularization parameters in patients with type 2 diabetes mellitus (DM), without diabetic retinopathy (DR), and to compare them to healthy controls.
Seventy-four eyes from 74 patients (40 eyes in the DM group and 34 eyes in the control group) were included in the study. Optical coherence tomography angiography RTVue XR Avanti was used to obtain 3×3mm scans of the macula. The choroidal vascularity index (CVI), superficial and deep capillary plexus vascular densities (SCP and DCP, respectively), and choroidal thickness (CT) were measured.
In the diabetic group, SCP was lower in the superior and nasal segments (48.68 vs 50.62, p=0.02; 45.50 vs 48.82, p=0.02, respectively). The DCP did not differ between the groups. CVI was significantly lower in the study group in all measured segments, including central and parafoveal (31.73 vs 48.86 and 50.32 vs 59.58, p<0.001, respectively). CT was larger in the study group only at the center of the macula (281.89µm vs 268.37µm p<0.001) and in the inferior segment (337.47µm vs 329.40µm, p<0.001). In the multivariate regression, clinical and vascularization parameters affecting CVI and CT were analyzed after adjusting for age and sex. Decreased central CVI was associated with the presence of DM, lower central SCP, and bigger foveal avascular zone area (b=-0.68, b=0.47, b=-0.21). Parafoveal CVI was also negatively affected by DM (b= -0.46) and positively by parafoveal SCP (b= 0.44). Increased central CT was found to be positively associated with higher central SCP (b=0.48) and male sex (b=0.20).
The results of our study confirmed a reduction of SCP and CVI in diabetic patients without DR. DM and SCP are age and sex independent parameters affecting CVI. Central CT is affected by SCP and sex, rather than the presence of diabetes.
本研究旨在评估无糖尿病视网膜病变（DR）的2型糖尿病（DM）患者的视网膜和脉络膜血管生成参数，并将其与健康对照者进行比较。
本研究纳入了74例患者的74只眼（DM组40只眼，对照组34只眼）。使用光学相干断层扫描血管造影RTVue XR Avanti获取黄斑区3×3mm扫描图像。测量脉络膜血管指数（CVI）、浅表和深部毛细血管丛血管密度（分别为SCP和DCP）以及脉络膜厚度（CT）。
在糖尿病组中，上方和鼻侧节段的SCP较低（分别为48.68对50.62，p = 0.02；45.50对48.82，p = 0.02）。两组之间的DCP没有差异。研究组所有测量节段的CVI均显著较低，包括中心和旁中心凹（分别为31.73对48.86和50.32对59.58，p < 0.001）。研究组仅在黄斑中心（281.89µm对268.37µm，p < 0.001）和下方节段（337.47µm对329.40µm，p < 0.001）的CT较大。在多因素回归分析中，在调整年龄和性别后分析影响CVI和CT的临床和血管生成参数。中心CVI降低与DM的存在、中心SCP降低以及黄斑无血管区面积增大有关（b = -0.68，b = 0.47，b = -0.21）。旁中心凹CVI也受到DM的负面影响（b = -0.46），并受到旁中心凹SCP的正面影响（b = 0.44）。发现中心CT增加与中心SCP升高（b = 0.48）和男性性别（b = 0.20）呈正相关。
我们的研究结果证实，无DR的糖尿病患者的SCP和CVI降低。DM和SCP是影响CVI的与年龄和性别无关的参数。中心CT受SCP和性别的影响，而非糖尿病的存在。
