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Abstract
Purpose
To investigate the systemic parameters related to changes in the retinal microvasculature using optical coherence to-mography angiography (OCTA) in diabetic patients without diabetic retinopathy.
Methods
We retrospectively reviewed the medical records of diabetic patients without diabetic retinopathy. All patients showed normal fundus on dilated fundus examinations. OCTA (DRI OCT Triton, Topcon Corporation, Tokyo, Japan) was performed on a 3 × 3 mm area centered at the fovea. The foveal avascular zone (FAZ) area and vascular density (VD) of the superficial and deep capillary plexus (SCP/DCP) were measured. Multiple regression analysis was conducted to evaluate the relationship be-tween microvascular indexes on OCTA and systemic parameters including sex, age, duration of diabetes mellitus (DM), hemo-globin A1c (HbA1c), total cholesterol, presence of hypertension (HTN) and systolic and diastolic blood pressure (SBP/DBP).
Results
A total of 35 eyes of 35 patients were included in this study. The mean age was 55.7 ± 11.6 years, the mean duration of DM was 52.4 ± 88.7 months and the mean HbA1c was 8.8 ± 2.3%. The FAZ area of the DCP increased significantly as the HbA1c level increased (p < 0.001), but the other parameters, i.e., sex, age, duration of DM, total cholesterol, presence of HTN, SBP and DBP, did not exhibit significant relations in the DCP (p = 0.727, 0.280, 0.385, 0.816, 0.206, 0.055 and 0.092, re-spectively). There were no significant relationships between systemic parameters and the FAZ area in the SCP (p > 0.05). No systemic parameters exhibited significant relationships with VD in either the SCP or the DCP (p > 0.05).
References
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Figure 1.
The optical coherence tomography angiography images of 2 subjects; a 30-year-old female patient with hemoglobin A1c level of 5.9% (A, C, E, G) and a 75-year-old male patient with hemoglobin A1c level of 13.4% (B, D, F, H). Foveal avascular zone area of the superficial (A, B) and deep capillary plexuses (E, F). Converted images of the superficial (C, D) and deep capillary plex-uses (G, H) by adjust threshold tool set to default of Image J to calculate vascular density.
Table 1.
The demographic and clinical characteristics of the participants
Table 2.
The relationship between the foveal avascular zone area of superficial capillary plexus and systemic parameters
| Variables | Univariate * | Multiple† | ||
|---|---|---|---|---|
| Coefficient | p-value* | Coefficient | p-value† | |
| Sex (female) | 0.228 | 0.188 | ||
| Age Duration of DM | 0.161 -0.143 | 0.355 0.411 | ||
| Duration of DM | -0.143 | 0.411 | ||
| HbA1c | 0.189 | 0.276 | ||
| Total cholesterol | 0.043 | 0.808 | ||
| Presence of HTN | 0.012 | 0.944 | ||
| SBP | -0.321 | 0.060 | -0.321 | 0.060 |
| DBP | -0.252 | 0.145 | ||
Table 3.
The relationship between the foveal avascular zone area of deep capillary plexus and systemic parameters
| Variables | Univariate | Multiple | ||
|---|---|---|---|---|
| Coefficient | p-value* | Coefficient | p-value† | |
| Sex (female) | 0.061 | 0.727 | ||
| Age | 0.188 | 0.280 | ||
| Duration of DM | -0.152 | 0.385 | ||
| HbA1c | 0.652 | <0.001 | 0.652 | <0.001 |
| Total cholesterol | -0.041 | 0.816 | ||
| Presence of HTN | -0.219 | 0.206 | ||
| SBP | -0.327 | 0.055 | -0.165 | 0.234 |
| DBP | -0.289 | 0.092 | -0.122 | 0.381 |
Table 4.
The relationship between the vascular density of superficial capillary plexus and systemic parameters
| Variables | Univariate | Multiple | ||
|---|---|---|---|---|
| Coefficient | p-value* | Coefficient | p-value† | |
| Sex (female) | 0.154 | 0.378 | ||
| Age | -0.289 | 0.092 | -0.215 | 0.213 |
| Duration of DM | -0.329 | 0.054 | -0.329 | 0.054 |
| HbA1c | -0.046 | 0.792 | ||
| Total cholesterol | -0.099 | 0.573 | ||
| Presence of HTN | -0.086 | 0.623 | ||
| SBP | -0.058 | 0.741 | ||
| DBP | 0.162 | 0.352 | ||
Table 5.
The relationship between the vascular density of deep capillary plexus and systemic parameters
| Variables | Univariate | Multiple | ||
|---|---|---|---|---|
| Coefficient | p-value* | Coefficient | p-value† | |
| Sex (female) | -0.029 | 0.869 | ||
| Age | -0.234 | 0.176 | ||
| Duration of DM | -0.298 | 0.082 | -0.298 | 0.082 |
| HbA1c | 0.001 | 0.995 | ||
| Total cholesterol | -0.180 | 0.300 | ||
| Presence of HTN | -0.278 | 0.106 | ||
| SBP | -0.108 | 0.536 | ||
| DBP | -0.062 | 0.722 | ||
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