Changes in Retinal Microcirculation Precede the Clinical Onset of Diabetic Retinopathy in Children With Type 1 Diabetes Mellitus
Changes in Retinal Microcirculation Precede the Clinical Onset of Diabetic Retinopathy in Children With Type 1 Diabetes Mellitus
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DOI：
10.1016/j.ajo.2019.04.011
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发表时间：
2019-11-01
影响因子：
4.2
通讯作者：
Aycan, Zehra
中科院分区：
文献类型：
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作者：
Inanc, Merve;Tekin, Kemal;Aycan, Zehra
目的：调查糖尿病 (DM) 中糖代谢异常是否影响控制良好的 1 型 DM 儿童的视网膜微循环，并将这些结果与健康儿童的结果进行比较。设计：横断面前瞻性研究。方法：本研究纳入了 60 名没有临床可检测到的糖尿病视网膜病变 (DR) 的 DM 患者和 57 名年龄匹配的对照受试者。使用AngioVue（Avanti，Optivue）进行光学相干断层扫描血管造影（OCT-A）。分析中心凹无血管区（FAZ）面积、非血流面积、浅层和深层血管密度、FAZ周长、FAZ无循环指数（AI；FAZ周长与等面积圆周长之比）和中心凹密度（FD-300；FAZ周围300μm内的血管密度）。在 1 型 DM 患者中评估了所研究的 OCT-A 参数与 DM 持续时间和糖化血红蛋白 (HbA1c) 水平之间的相关性。 结果：FAZ 周长、AI 和 FD-300 的平均值在 DM 组和对照组之间具有统计学显着性差异（分别为 P < .001、P = .001 和 P = .009）。各组之间深上半旁中心凹、深颞旁中心凹和深上旁中心凹区的血管密度也存在统计学显着差异（分别为 P = .008、P = .015 和 P = .005）。 DM 持续时间和 HbA1c 水平与所研究的 OCT-A 参数之间没有显着相关性。结论：临床上未检测到 DR 的糖尿病眼在 FAZ 扩大之前表现出 FD-300、AI、周长和深部毛细血管丛中中心凹旁毛细血管的血管密度的变化；因此，这些新参数可能是定义早期 DR 的敏感成像生物标志物。 44. (C) 2019 Elsevier Inc. 保留所有权利。
PURPOSE: To investigate whether abnormal glucose metabolism in diabetes mellitus (DM) affects the retinal microcirculation of children with well-controlled type 1 DM and to compare these results with those obtained from healthy children.DESIGN: Cross-sectional prospective study.METHODS: This study enrolled 60 patients with DM without clinically detectable diabetic retinopathy (DR) and 57 age-matched control subjects. Optical coherence tomography angiography (OCT-A) was performed using AngioVue (Avanti, Optivue). Foveal avascular zone (FAZ) area, nonflow area, superficial and deep vessel densities, FAZ perimeter, acircularity index of FAZ (AI; the ratio of the perimeter of FAZ and the perimeter of a circle with equal area), and foveal density (FD-300; vessel density in 300 mu m around FAZ) were analyzed. Correlations between the investigated OCT-A parameters with DM duration and glycated hemoglobin (HbA1c) levels were evaluated among patients with type 1 DM.RESULTS: Differences in the mean values for FAZ perimeter, AI, and FD-300 were statistically significant between DM group and control group (P < .001, P = .001, and P = .009, respectively). There were also statistically significant differences between the groups for vessel densities of deep superior hemiparafovea, deep temporal parafovea, and deep superior parafoveal zones (P = .008, P = .015, and P = .005, respectively). There were no significant correlations between DM duration and HbA1c levels with the investigated OCT-A parameters.CONCLUSION: Diabetic eyes without clinically detectable DR exhibited alterations in FD-300, AI, perimeter, and vessel density of parafoveal capillaries in deep capillary plexus preceding the enlargement of FAZ; therefore, these new parameters might be sensitive imaging biomarkers to define early DR. 44. (C) 2019 Elsevier Inc. All rights reserved.