Assessment of early macular microangiopathy in subjects with prediabetes using optical coherence tomography angiography and fundus photography

Abstract

Aims Early detection of retinal microangiopathy in patients with prediabetes may reduce diabetic retinopathy complications. The aim of this study was to assess early macular vascular changes in prediabetics before development of over diabetes using OCTA and fundus photography. Methods In this cross-sectional study, 66 prediabetic individuals and 66 normal controls underwent clinical, laboratory, and fundus photography evaluation followed by OCTA macular imaging to examine for the foveal avascular zone, and area of capillary non-perfusion, thickness, disorganization of vessels, and vessel density perfusion percentage of superficial capillary plexus and deep capillary plexus. Results Retinal microangiopathy was detected in 36.4% of prediabetics by OCTA and only in 10.6% by fundus photography. None of clinical or laboratory parameters had significant association with DR. Area of capillary non-perfusion and disorganization of SCP were detected in 53.8% and 56.8%, respectively, in prediabetics. VDP of SCP and DCP of whole image, parafoveal, and perifoveal areas was significantly lower in prediabetes group compared to normal control. VDP of DCP of perifoveal area (β coefficient: − 0.10, OR: 0.91, 95% CI: 0.86–0.96, P < 0.001) and disorganization of DCP (β coefficient: 1.93, OR: 6.89, 95% CI: 2.5–18.8, P < 0.001) were significant predictors of DR in prediabetics. There was no difference in FAZ in prediabetics with and without retinopathy. Conclusions OCTA could detect early retinal vascular changes during the prediabetic state before developing diabetes. VDP was significantly reduced in prediabetic patients. Furthermore, VDP of DCP of perifoveal area and disorganization of DCP were the most important predictors of retinopathy in prediabetic patients.

Evaluation of Foveal Avascular Region and Macular Blood Vessel Density in Prediabetic Patients with OCT-A Findings

“…However, another study reported that the percentage of SCP and DCP vessel density perfusion (VDP) was signi cantly lower in prediabetics compared to the control group (23). In addition, Arias et al revealed that vessel density and perfusion density decreased in prediabetics compared to the control group (24). In our study, we found a statistically signi cant decrease in plexus perfusion density in the temporal quadrant of the SCP and the inferior and temporal quadrants of the DCP.…”

Optical Coherence Tomography Angiography as a Diagnostic Tool for Diabetic Retinopathy

“…One study looked at a new parameter, microangiopathy, on OCTA. El Sawy et al were able to detect retinal microangiopathy in 36.4% of pre-diabetics, capillary NPA in 53.8%, and the disorganisation of the SCP in 56.8% of pre-diabetic patients, compared to only 10.6% detected in CFP [136].…”