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Cecilia Czakó, Gabor Laszlo Sandor, Mónika Ecsedy, Zsuzsa Récsán, Hajnalka Horváth, Zoltán Zsolt Nagy, Illes Kovacs; Decreased capillary vessel density is associated with a higher risk of diabetic retinopathy in patients with diabetes . Invest. Ophthalmol. Vis. Sci. 2018;59(9):1932.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify retinal microvasculature alterations using optical coherence tomography angiography (OCT-A) in diabetic patients, and to evaluate their predictive accuracy on the development of diabetic retinopathy.
102 eyes of 51 diabetic patients and 92 eyes of 46 individuals without diabetes underwent OCT-A imaging (RTVue-XR Avanti; Optovue, Fremont CA, USA). In diabetic patients, duration of diabetes, insulin therapy, blood pressure, HbA1C, dyslipidemia, axial length and the presence of diabetic retinopathy was recorded. Retinal vessel density (VD) was measured in the central macula with a radius of 3 mm by optical coherence tomography angiography. The effect of risk factors on VD and on diabetic retinopathy was assessed using uni- and multivariable regression analysis.
Vessel density was significantly decreased in diabetic patients compared to controls (47.26 vs. 50.88%; p<0.001). In controls, VD correlated with age (r= -0.54; p<0.001), while in diabetic patients VD was associated only with diabetes duration (p=0.02) among risk factors. VD was also significantly decreased in diabetic patients without clinically detectable diabetic retinopathy compared to control subjects (48.19 vs. 50.88%, p<0.001). Lower VD was a significant predictor of diabetic retinopathy (OR: 1.24, p=0.009) after controlling for systemic and ocular confounding variables. Eyes with a VD of <50% had an odds ratio of 4.55 (p=0.003) for diabetic retinopathy and an odds ratio of 3.22 (p=0.03) for decreased visual acuity (<20/25) after controlling for systemic and ocular confounding factors.
Significantly decreased retinal vessel density can be measured in diabetic patients compared to control subjects even before the presence of clinically detectable diabetic retinopathy. The risk of diabetic retinopathy and vision loss seems to be substantially higher in eyes with lower vessel density independently of the systemic risk factors suggesting the need for a closer follow-up of these patients.
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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