Prediabetic early microvascular changes detected by optical coherence tomography angiography

Author: Eduardo Viteri (Ecuador)

Co-authors: Juan David Arias, Francisco J. Arango, M. Margarita Parra, Ronald Sánchez-Ávila, Gustavo Parra Serrano, Silvia J. Granados

Purpose

To determine early microvascular changes in patients with prediabetes using optical coherence tomography angiography (OCT-A).

Setting/Venue

Tertiary referral center FOSCAL International in Colombia

Methods

Single-centre retrospective case-control study. Macular OCT-A images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed in non-diabetic controls, prediabetic and diabetic subjects. A quantitative analysis was performed using the ImageJ software of the foveal avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD) and vascular density (VD).

Results

A total of 94 eyes of 53 patients were included in this study. The global mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, mean PD was 0.283±0.15, 0.186±0.720 and 0.186 ± 0.07, in non-diabetic controls, prediabetics and diabetic groups respectively. Mean VD was 8.728 ± 3.425 in non-diabetic controls, 6.147 ± 1.399 in prediabetics, and 6.292 ± 1.997 in patients with diabetes. The comparison of prediabetic patients and controls show statistical differences between PD and VD in both plexus SCP (p=0.002 and p=0.001 respectively) and DCP (p=0.005 and p=0.002 respectively). The mean area of FAZ in the SCP in patients with diabetes and normal individuals was 0.281 mm 2 and 0.196 mm 2 respectively (p<0.001). AI was higher in the control group (0.87 ± 0.14) and prediabetic (0.80 ± 0.17) compared to diabetic patients (0.64 ± 0.19). There were no differences in FAZ area and AI between prediabetics and non-diabetic controls.

Conlusions

PD and VD demonstrated to be early microvascular changes in prediabetic patients evaluated by OCT-A. On the other hand, alterations of FAZ were not evidenced.

Financial Disclosure

Coauthor Juan David Arias is a consultant for Topcon