Correlation of advanced glycation end products with retinal parameters measured with OCTA in diabetic patients

Abstract

Purpose : The aim of this study was to evaluate the association of the degree of diabetic retinopathy in type 1 (T1D) and type 2 (T2D) diabetes patients with advanced glycation end products (AGEs) and retinal parameters assessed by optical coherence tomography angiography (OCTA).

Methods : A single-centre prospective cross-sectional study included 95 eyes of 95 patients (female 73.7%; median age 65 years (49.0-71.5); median diabetes duration 15 years (8.0-25.0)) with T1D (36.8%) and T2DM (63.2%). Exclusion criteria were significant chronic systemic or ocular diseases other than diabetes. The subjects were divided into two groups: without DR and with DR. OCTA (Optovue Solix FullRange) images were processed to quantify foveal avascular zone (FAZ) area (mm²), macular vessel density (VD) in superficial (SCP) and deep (DCP) capillary plexus (%) and flow in the outer retina and choriocapillaris. AGEs risk groups (0-normal, 1- mild risk, 2- intermediate risk, 3- high risk) were determined using AGE reader (Diagnoptics). Statistical analysis was performed using Rstudio: Kruskal-Wallis, Wilcoxon, Fisher, Chi-square test.

Results : Median age was higher in the DR group- 57 years (42.0-67.0) compared to the group without DR- 70 years (53.3-74.8), p=0.0018. The group with DR had higher risk groups of AGEs than the group without DR (p<0.001). AGEs risk groups were advanced with longer duration of diabetes (p<0.001) and in the group with DR (p<0.001). There was a significant difference between the AGEs risk groups and:1) age of the subjects, p<0.001, and 2) VD at DCP, p=0.017. There was no significant association between the groups: no DR and DR: 1) mean FAZ area (all subjects 0.27 mm²), p=0.196); 2) VD at SCP (all subjects 46.8%, p=0.31); 3) VD in DCP (all subjects 50.4%, p=0.55). There was no significant correlation between the AGEs risk group and: 1) VD in SCP, p=0.23; 2) FAZ area, p=0.26; 3) flow in the outer retina, p=0.053 and choriocapillaris, p=0.22; 4) arterial blood pressure, p=0.76. There was no significant correlation between FAZ area and: 1) VD in SCP (r=-0.20); 2) VD in DCP (r=-0.14); 3) DR stage (p=0.20); 4) duration of diabetes (p=0.27).

Conclusions : Quantitative evaluation of retinal microvasculature and AGEs levels can be used as an non-invasive biomarkers of vascular health. Further research is needed to use these parameters as prognostic factors in the assesment of diabetic retinopathy.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.