Background: To study choroidal thickness (CT) in type 2 diabetes mellitus (DM2) patients with moderate diabetic retinopathy (DR) and to correlate with changes in retinal thickness (RT) with swept-source OCT (SS-OCT) compared to healthy subjects. Methods: Fifty-four DM2 patients with moderate DR without diabetic macular edema (DME) and 73 age-matched healthy subjects were evaluated using SS-OCT to measure changes in total RT and CT in the nine areas of the Early Treatment Diabetic Retinopathy Study (ETDRS) macular grid. Results: The mean age was 64.06 ± 11.98 years and 60.79 ± 8.62 years in the diabetic and control groups, respectively. Total RT showed statistically significant differences in the temporal inner area, with higher values in the DM2 group (p = 0.010,). CT did not show differences between the groups. There was a significant negative correlation between RT and age in all of the outer ETDRS areas and a positive significant correlation in the central area for the DM2 group. There was also a negative significant correlation between CT and age in all of the ETDRS areas except for the inferior inner area. In the DM2 group, a negative correlation was observed between RT and CT in the central area (p = 0.039) and in both horizontal parafoveal areas (temporal inner, p = 0.028; nasal inner, p= 0.003). Conclusion: DM2 patients with moderate DR have no changes with regard to CT. Both CT and RT decreased with age in DM2, showing a negative correlation between these factors in the central and horizontal parafoveal areas of the ETDRS grid.
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Purpose: To study choroidal thickness (CT) in type 2 diabetes mellitus (DM2) patients with moderate diabetic retinopathy (DR) without diabetic macular edema (DME) and to correlate with changes in retinal thickness (RT) with swept source OCT (SS‐OCT)) compared to healthy subjects. Methods: Fifty‐four DM2 patients with moderate DR without DME and 73 age‐matched healthy subjects were evaluated using SS‐OCT to measure changes in total RT and the CT in the nine areas of the Early Treatment Diabetic Retinopathy Study (ETDRS) macular grid. Results: The mean ages were 64.06 ± 11.98 years and 60.79 ± 8.62 years in the diabetic and control groups, respectively. Visual acuity (VA) with ETDRS 100% was lower in the DM2 patients (p < 0.001). In the total RT, statistically significant differences were found in the temporal inner area being thicker thickness in the DM2 group (260.70 ± 19.22 μm vs. 271.90 ± 37.61 μm with p = 0.010, in control and DM2 group, respectively). The CT did not show significant differences between both groups (p > 0.05) in any ETDRS area. There was a significant negative correlation between RT and age in all of the external ETDRS areas and a positive significant correlation in the central area for DM2 group. There was also a negative significant correlation between CT and age in all ETDRS areas except for the inferior inner area. In the DM2 group, a negative correlation was observed between RT and CT in the central area (p = 0.039) and in both horizontal parafoveal areas (temporal inner: p = 0.028, central: p = 0.039 and nasal inner: p = 0.003). Conclusions: DM2 patients with moderate DR have no changes in CT. CT and RT decrease with age and show a negative correlation with RT in the central and horizontal parafoveal areas of the ETDRS grid.
Purpose: To study anatomical and vascular changes in the superficial capillary (SCP) and deep capillary (DCP) plexuses in the retina, as well as changes in the choriocapillaris (CC) and foveal avascular zone (FAZ) using optical coherence tomography angiography (OCTA) in type 1 diabetic (DM1) patients without diabetic retinopathy (DR). Methods: We performed a single‐center cross‐sectional descriptive study including 68 eyes of well‐controlled DM1 patients who had been diagnosed at least 10 years prior, and 88 eyes of 88 healthy subjects. All participants underwent a full ophthalmic examination including OCTA using Deep Range Imaging (DRI)‐Triton swept source (SS)‐OCT. Results: six eyes were excluded from the DM1 group after checking the quality of our measurements, resulting in a final sample of 62 eyes. Mean age was 43.79 ± 11.31 and 47.16 ± 15.48 years in the DM1 group and in the control group respectively. There were no differences in VA, EE, AL nor IOP. Statistically significant differences were found in all areas of the SCP, except for the central area, with lower values in DM1 patients. There were differences in all quadrants except the central zone and the superior quadrant in the DCP. In the CC, there were only significant blood flow changes in the central area. We did not find significant differences in the FAZ in neither of the plexuses, but the horizontal FAZ SCP diameter was found significantly different. The anatomical evaluation frequently showed abnormalities such as microaneurysms in both plexuses, FAZ modifications and areas with lack of blood perfusion. Conclusions: Type 1 diabetic patients without DR present microvascular abnormalities with lack of retinal and CC blood perfusion, as well as anatomical changes in retinal blood vessels.
Purpose: To assess anatomical changes in the retinal superficial capillary (SCP) and deep capillary (PCP) plexuses, as well as choriocapillary (CC) in patients with diabetes mellitus (DM) without diabetic retinopathy (DR), and in DM patients with mild and moderate DR without diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods: Ninety eyes were included, 34 patients with long‐term DM (more than 10 years) but without DR signs, and 54 patients with mild or moderate DR (levels 35 and 43 on the ETDRS scale) without DME. All participants underwent a complete ophthalmic examination including best corrected visual acuity (BCVA) and OCTA examination using deep‐range imaging with the DRI‐Triton SS‐OCT. Results: The mean age was 63.82 ± 8.56 years and 63.00 ± 13.21 years in long‐term DM without DR and with DR, respectively. In patients with long‐term DM without DR, foveal avascular zone (FAZ) abnormalities were seen in both SCP and DCP (55% and 5%), and microaneurysms (MAs) were present in SCP and DCP (35% and 47.5%). Loss of perfusion was detected in SCP and DCP (30% and 47.5%), and ischemia was observed in SCP, DCP and CC (60%, 37.5% and 10%). In patients with mild or moderate DR without DME, OCTA also detected morphological abnormalities such as FAZ changes and MAs (79.6% and 81.11%), loss of perfusion (83.3% and 64.2%), and ischemia (66.67%, 81.1% and 18.5%) in SCP, DCP and CC respectively. Microvascular tortuosity and intraretinal microvascular anomalies (IRMAs) were detected in 48.1% and 46.3% in SCP vs 22.6% and 20.8% in DCP, respectively. Conclusions: Patients with long‐term DM without DR present morphological changes measured with OCTA, such as MAs in both retinal plexuses. The changes in the FAZ are more evident in the SCP due to the capillary anastomosis. Capillary dropout can be found in both plexuses. Patients with DR show more evident changes that include MAs, loss of perfusion and ischemia and other vascular abnormalities.
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