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Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 3/2020

01-03-2020 | Angiography | Retinal Disorders

Microvascular retinal changes in pre-clinical diabetic retinopathy as detected by optical coherence tomographic angiography

Authors: Jing Yan Yang, Qian Wang, Yan Ni Yan, Wen Jia Zhou, Ya Xing Wang, Shou Ling Wu, Ming Xia Yuan, Wen Bin Wei, Jost B. Jonas

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2020

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Abstract

Purpose

To investigate microvascular abnormalities in diabetic patients without conventional clinical signs of diabetic retinopathy (DR).

Methods

In this cross-sectional observational cohort study, the study group included randomly chosen participants of a community-based cohort with diabetes type 2 without DR, and the control group consisted of non-diabetic individuals from a population-based study. All participants underwent optical coherence tomographic angiography (OCTA).

Results

Upon OCTA, 118 (40.4%) eyes of the study group (n = 292 eyes) showed microvascular abnormalities including foveal avascular zone erosion (95 (32.5%) eyes), non-perfusion areas in the superficial and deep retinal layers (39 (13.4%) eyes and 19 (6.5%) eyes, respectively), and microaneurysms in the superficial and deep retinal layers (22 (7.5%) eyes and 31 (10.6%) eyes, resp.). None of these abnormalities was detected in the control group (n = 80). The study group showed a lower vessel density in the superficial retinal vascular layer in all regions except for the foveal region (P < 0.001), and higher vessel density in the parafoveal region in the deep retinal vascular layer (P = 0.01). Higher diabetes prevalence was associated with lower superficial retinal vascular density (P = 0.005) in multivariable analysis. A lower radial peripapillary capillary flow density was correlated (regression coefficient r, 0.62) with higher fasting blood concentration of glucose (P < 0.001) in multivariable analysis.

Conclusions

OCTA revealed microvascular abnormalities in 40% of eyes of diabetic patients without ophthalmoscopically detectable diabetic fundus changes in a community-based population. The early stage of DR may be re-defined upon OCTA.
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Metadata
Title
Microvascular retinal changes in pre-clinical diabetic retinopathy as detected by optical coherence tomographic angiography
Authors
Jing Yan Yang
Qian Wang
Yan Ni Yan
Wen Jia Zhou
Ya Xing Wang
Shou Ling Wu
Ming Xia Yuan
Wen Bin Wei
Jost B. Jonas
Publication date
01-03-2020
Publisher
Springer Berlin Heidelberg
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-019-04590-x

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