Abstract
Purpose :
Diabetic retinopathy (DR), a common complication of diabetes, correlates with arterial stiffness, a predictor of cardiovascular risk. The Cardio-Ankle Vascular Index (CAVI), reflecting arterial elasticity from the heart to the ankle, is influenced by coronary risk factors. High CAVI scores suggest increased cardiovascular risk. The relationship between arterial stiffness and ocular microcirculation in DR patients, however, has not been fully clarified. This study investigates the link between ocular microcirculation—specifically, choroidal blood flow characteristics measured by laser speckle flowgraphy (LSFG)—and CAVI in patients with DR caused by type 2 diabetes.
Methods :
In a cohort of seventy-two DR patients (mean age 61.2 years), we measured and assessed choroidal blood flow using LSFG analyzer. This included mean blur rate (MBR), pulsatility as shown by beat strength (BS), and the low-frequency (LF) component, which is associated with autonomic nervous function, in both macular and nasal regions. We used single and multiple regression analyses to pinpoint factors that independently correlate with CAVI scores.
Results :
CAVI scores exhibited a significant positive correlation with age, BS, and LF in both nasal and macular regions. However, MBR showed no significant correlation. Multiple regression analysis highlighted age (t = 3.587, p < 0.001) and LF (t = 1.789, p = 0.08) in the macular region as significant indicators of CAVI. The equation for the regression model is: CAVI = 0.466 * Age + 0.232 * LF (Adjusted R-squared = 0.33, P < 0.001).
Conclusions :
Significant associations between choroidal pulsatility, LF, and CAVI were observed, independent of the influences of age and LF alone. These results suggest that systemic physiological aging and vascular stiffness may be gauged by LF parameters in choroidal blood flow. The link between these parameters highlights the potential of LF measures in choroidal blood flow for assessing systemic health in patients with DR.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.