Abstract
Purpose :
To determine changes in the perifoveal vascular network measured by Optical Coherence Tomography Angiography (OCT-A) in Type I diabetic patients from diagnosis and insulin treatment start to one year follow-up.
Methods :
Case series study of 26 eyes (13 patients) of newly diagnosed type I diabetes mellitus (DM) patients started on insulin therapy from August 2016 to June 2017. Patients who did not complete one year follow up were excluded from the study. A complete ophthalmological examination including 6x6 mm OCTA images captured with Angioplex (Cirrus, Carl-Zeiss Meditec Inc., Dublin, CA, USA) was carried out. Changes in the Foveal Avascular Zone (FAZ), vessel density and perfusion density determined by the built-in manufacturer software were evaluated.
Results :
A significant increase in global vessel density (+1.74, SD: 2.61; p=0.009) was detected from diagnosis to 6 months. However, a reduction in this parameter was observed from 6 to 12 months (-0.92, SD: 3.04; p=0.042). Overall, a small increase in the global vessel density was observed from baseline to 12-month follow-up (+0.48, SD: 3.04; p=0.022). The mean change on the FAZ area show an increase at 6 months (+0.45, SD: 0.64, p<0.001) which subsequently declined from 6 to 12 months (-0.2, SD: 0.86; p<0.001). Similarly, to vessel density, the global results showed greater FAZ area at 12 months compared to baseline (0.28, SD:0.86, p<0.001). No statistically significant differences were found on the global perfusion parameter at one year follow up.
Conclusions :
Our results suggest that in newly diagnosed Type I diabetes patients during the first 6 months the macular area suffers a transient increase in vessel density and FAZ area, which appears to decrease slightly at 12 month. Further studies are needed in order to validate these results and determine the clinical relevance of this possible self-regulated vascular remodeling process.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.