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Qi Chen, Fan Tan, Meixiao Shen, Fan Lu, Chaoming Wu, Xiran Zhuang; Lower Macular Vascular Density and Larger Foveal Avascular Zone Area in Diabetic Patients and its Risk of Diabetic Retinopathy Using Optical Coherence Tomography Angiography. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2796.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the utility of quantify macular vascular density (MVD) and foveal avascular zone (FAZ) area with optical coherence tomography angiography (OCT-A) to detect subtle retinal capillary abnormality in type 2 diabetic patients and its relationship with diabetic retinopathy (DR) after adjusting the risk factors.
A perspective study. One hundred and thirty one patients with type 2 diabetes (80 with no DR, 36 with mild non-proliferative diabetic retinopathy [NPDR] and 15 with moderate to severe NPDR), and 60 control subjects were recruited. All subjects underwent a series of ophthalmologic examinations, and OCT-A scanning around the macula was performed subsequently. The 3 mm-diameter area of total annular zone (TAZ) (excluding the FAZ) was were subdivided to four quadrants. AngioVue software equipped in the OCT-A system were used to quantify MVD and FAZ area, and the multiple logistic regressions were then used to determine the odds ratio (OR) for DR.
A total of 202 diabetic eyes were enrolled, including no DR (NDR, n=129 eyes), mild non proliferative DR (n=52 eyes), and moderate to severe NPDR (n=21 eyes). Mean FAZ area was found significantly larger in NPDR, compared with control eyes (P=0.005), but there was no significant difference in patients with no DR (P=0.926). Compared to control eyes, MVD in TAZ and each quadrant was lower in no DR (P<0.01), as well as in NPDR (P<0.001). After adjustment for risk factors (including age, gender, body mass index, mean arterial pressure, intraocular pressure, duration of DR, HbA1c, total cholesterol, high and low-density lipoprotein cholesterol), decreasing MVD and increasing FAZ area were significantly associated with increasing odds of DR (OR: 26.077 [95% CI 4.821–141.038] and 0.118 [95% CI 0.024–0.586], respectively).
Diabetic patients were demonstrated to have decreasing MVD and increasing FAZ area using OCT-A. The higher prevalence of DR was also found in patients with lower MVD and Larger FAZ area, which was independent of systematic risk factors. OCT-A was considered as a promising tool for detecting early microvasculature impairment in diabetic patients and may have a role in the monitoring for DR.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Representative Fundus Photographs and OCT-A Images of control and diabetic eyes.
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