Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus—Report 2: Diabetic Kidney Disease

Abstract

The purpose of this study is to investigate potential associations between optical coherence tomography angiography (OCTA) parameters and diabetic kidney disease (DKD) categories in type 1 diabetes mellitus (T1DM) patients and controls. A complete ocular and systemic examination, including OCTA imaging tests and bloods, was performed. OCTA parameters included vessel density (VD), perfusion density (PD), foveal avascular zone area (FAZa), perimeter (FAZp) and circularity (FAZc) in the superficial vascular plexus, and DKD categories were defined according to glomerular filtration rate (GFR), albumin-creatinine ratio (ACR) and KDIGO prognosis risk classifications. A total of 425 individuals (1 eye/1 patient) were included. Reduced VD and FAZc were associated with greater categories of GFR (p = 0.002, p = 0.04), ACR (p = 0.003, p = 0.005) and KDIGO risk prognosis classifications (p = 0.002, p = 0.005). FAZc was significantly reduced in greater KDIGO prognosis risk categories (low risk vs. moderate risk, 0.65 ± 0.09 vs. 0.60 ± 0.07, p < 0.05). VD and FAZc presented the best diagnostic performance in ROCs. In conclusion, OCTA parameters, such as VD and FAZc, are able to detect different GFR, ACR, and KDIGO categories in T1DM patients and controls in a non-invasive, objective quantitative way. FAZc is able to discriminate within T1DM patients those with greater DKD categories and greater risk of DKD progression.

Association of advanced chronic kidney disease with diabetic retinopathy severity in older patients with diabetes: a retrospective cross-sectional study

“…Cankurtaran et al [ 36 ] reported that vessel densities in the superficial capillary plexus, whole disc, and peripapillary area were significantly different depending on the presence of diabetic albuminuria, even in the absence of DR. In other studies, patients with either type 1 or type 2 DM showed a decrease in the quantitative parameters identified by OCTA in diabetic nephropathy [ 37 , 38 ]. Although our study did not evaluate OCTA quantitative parameters and simply confirmed the relationship between DR severity and diabetic nephropathy, meaningful results can be expected if such OCTA parameters are used in the analysis in future studies.…”

Oculomics: A Crusade Against the Four Horsemen of Chronic Disease

“…Alé-Chilet et al (2021) published an original report on features of OCTA that are associated with diabetic kidney disease [ 130 ]—one of the many complications of diabetes. Diabetic kidney disease usually develops 5 years after type 1 diabetes diagnosis and occurs in 20–40% of patients with diabetes.…”

Radiomics-Based Assessment of OCT Angiography Images for Diabetic Retinopathy Diagnosis

“…A total of 593 individuals with retinal images corresponding to 1186 eyes and ocular and systemic data were recruited, 478 patients with type 1 DM (n = 956 eyes) and 115 healthy controls (n = 230 eyes). Systemic, ocular, and retinal images quality exclusion criteria were applied as described elsewhere 39 , 40 41 and 439 individuals (n = 726 eyes) with a complete battery of all retinal images constituted the primary dataset for analysis. To evaluate the influence of a potential bilaterality bias, a secondary analysis was conducted by randomly selecting only 1 eye per patient (1 eye/1 patient) that included 439 patients (n = 439 eyes).…”