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Anibal Alé-Chilet, Marina Barraso, Teresa Hernandez, Cristian Oliva, Alfredo Adán, Javier Zarranz-Ventura; Cardiovascular risk factors impact in perifoveal flow in Type 1 Diabetes Mellitus (T1DM) assessed by OCT Angiography (OCTA). Invest. Ophthalmol. Vis. Sci. 2018;59(9):1907.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the impact of cardiovascular risk factors in OCTA-derived parameters in a cohort of T1DM
269 consecutive T1DM patients (randomized 1 eye = 1 patient) with recent full blood tests referred prospectively from Endocrinology to the Ophthalmology service (Hospital Clinic, Barcelona) underwent a complete ophthalmic examination with comprehensive OCT and OCTA scanning protocols (OCTA 3x3 mm, 6x6 mm, Cirrus Zeiss Angioplex). Clinical data collected included age, sex, BMI, systemic treatments, disease duration, insulin dose and smoking habits. Systemic markers included full blood count, lipid profile (triglycerids, total cholesterol, LDL, HDL) and kidney function test (blood and urine). OCTA-derived parameters were obtained with the commercial software (Angioplex Metrix, v10.0.0.14618), and included vessel density (VD), perfusion density (PD) and foveal avascular zone (FAZ) perimeter, area and circularity
Significant differences were found between OCTA parameters and smoking status (6x6 external VD p=0.045, 6x6 complete VD p=0.045), BMI (3x3 inner VD p<0.001, 3x3 complete VD p<0.001), arterial hypertension (3x3 central VD p=0.02, 3x3 inner VD p=0.013, 3x3 complete VD p=0.007), elevated triglyceridemia (over 150mg/dl) (6x6 inner VD p=0.033, 6x6 inner PD p=0.027), antiplatelets (3x3 central VD p=0.004, 3x3 inner VD p=0.001, 3x3 complete VD p<0.001, 3x3 inner PD p=0.025, 3x3 complete PD p=0.007, 6x6 complete PD p=0.041) and statins therapy (p=0.026). No significant differences were found comparing by elevated LDL (over 100mg/dl), HDL, insulin pump vs inyections nor oral antidiabetic therapy.
OCTA can characterize with high detail the perifoveal capillary flow in T1DM patients in a non invasive way, showing differences in relation to the systemic control of the disease. This way this technology could identify what T1DM patients are in risk to develop atherosclerotic cardiovascular disease.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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