Relationship between Size of the Foveal Avascular Zone and Carbohydrate Metabolic Disorders during Pregnancy

Abstract

Aim To determine whether the area of the foveal avascular zone (FAZ), as a morphological indicator of the microcirculation of the perifoveal capillary network, changes in the carbohydrate metabolism disorders during pregnancy (the gestational age of patients with gestational diabetes mellitus (GDM) and preexisting diabetes (PexD)). Methods Ten normal individuals and 41 eyes of 41 patients, 28 with GDM and 13 with PexD, were studied. A 3 × 3 mm area of the FAZ of the superficial capillary plexus layer (SCP) and the deep capillary plexus layer (DCP) was determined by optical coherence tomography angiography (OCTA; RS-3000 Advance, NIDEK). The significance of the correlation between the size of the FAZ and the weeks of pregnancy was determined. Results The area of the FAZ of the SCP was 0.38 ± 0.11 mm2 (normal eyes), 0.41 ± 0.16 mm2 (GDM), and 0.43 ± 0.10 mm2 (PexD). The area of the FAZ of the DCP was 0.78 ± 0.23 mm2 (normal eyes), 0.69 ± 0.16 mm2 (GDM), and 0.79 ± 0.25 mm2 (PexD). No significant difference in the FAZ sizes was observed between the groups. The average number of weeks of pregnancy was 24.1 ± 8.2 weeks in the eyes with GDM and 23.3 ± 11.4 weeks in the eyes with PexD (P > 0.05). Significant correlations were found between the size of the FAZ of the SCP and the number of weeks (r = 0.37, P=0.04 for GDM, and r = 0.49, P=0.04 for PexD, Spearman's rank-order correlation coefficient). Conclusions For GDM and PexD under established glycemic control, the area of the FAZ is not affected, but vascular changes occurred at the early phase of pregnancy.

Optical Coherence Tomography Angiography Evaluation of Retinochoroidal Microvascular Circulation Differences in Pregnant Women with Pregestational and Gestational Diabetes Mellitus

“…The FAZ area is another important OCTA parameter that is frequently examined in diabetic retinopathy. In a previous study, FAZ area size did not differ significantly in either early or late stages, but a decrease in FAZ area was observed with an increasing number of weeks of gestation in the pregnant group with diabetes [31] . In addition, it has been reported that FAZ areas during pregnancy under established glycemic control were not significantly different from those of non-pregnant women [31].…”

“…In a previous study, FAZ area size did not differ significantly in either early or late stages, but a decrease in FAZ area was observed with an increasing number of weeks of gestation in the pregnant group with diabetes [31] . In addition, it has been reported that FAZ areas during pregnancy under established glycemic control were not significantly different from those of non-pregnant women [31]. In our study, although there was no difference in FAZ measurements between pregnant subjects with PGDM and GDM, we found a decrease in FAZ area in the PGDM group as HbA1c increased.…”