Sub-Clinical Regional Macular Changes in Self-Reported Diabetic Subjects: Vascular and Retinal Layer Analysis Using Swept-Source OCT.

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Naveen Kumar Challa, Waleed M Alghamdi, Muhammed S Alluwimi, Saleh Alshammeri
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Abstract

Aim: To assess and compare subclinical alterations in superficial capillary plexus vessel density (SCPVD) and retinal layers thickness in the macular region between individuals with type 2 diabetes mellitus (DM) and healthy controls.

Methods: Swept-source OCT images were obtained from 29 control subjects and 24 diabetic subjects. Macular thickness (MT), retinal nerve fiber layer (RNFL) thickness, and ganglion cell layer (GCL) thickness were measured in the central macula and four quadrants of macular region using a 6.0 × 6.0 mm radial macular scan centered on the fovea. OCTA acquisition included a 3.0 × 3.0 mm macular scan for the foveal avascular zone (FAZ) and a 4.5 × 4.5 mm macular scan for SCPVD. The FAZ was manually mapped at the SCP on OCTA images.

Results: In diabetic subjects, the superficial capillary plexus vessel density (SCPVD) was significantly lower in both the central (P = 0.04) and inferior (P = 0.01) regions compared to the control group. Additionally, diabetic patients showed a significant reduction in temporal macular thickness (MT) and thinning of the ganglion cell layer (GCL) in all three quadrants except in the central and inferior macula (P < 0.05). There was also significant thinning of the superior macular retinal nerve fiber layer (RNFL) in diabetics compared to controls (P = 0.02). While the foveal avascular zone (FAZ) was larger in diabetic subjects, this difference was not statistically significant (P = 0.78). Duration of diabetes has shown a significantly high positive correlation (r = 0.77, P < 0.01) with superior macular VD.

Conclusion: The findings of this study suggest that the diabetic macula experiences significant ganglion cell layer (GCL) thinning and reduced superficial capillary plexus (SCP) vascular density even before the onset of clinical retinopathy. Swept-source OCT proves to be an essential tool for detecting these early changes in diabetic patients.

自述糖尿病受试者的亚临床区域性黄斑变化:使用扫源 OCT 分析血管和视网膜层
目的:评价和比较2型糖尿病(DM)患者与健康对照者黄斑区浅毛细血管丛血管密度(SCPVD)和视网膜层厚度的亚临床变化。方法:29例正常对照和24例糖尿病患者的扫描源OCT图像。采用以中央凹为中心的6.0 × 6.0 mm黄斑放射状扫描,测量黄斑中央和黄斑区域四个象限的黄斑厚度(MT)、视网膜神经纤维层(RNFL)厚度和神经节细胞层(GCL)厚度。OCTA采集包括对中央凹无血管区(FAZ)进行3.0 × 3.0 mm黄斑扫描,对SCPVD进行4.5 × 4.5 mm黄斑扫描。在OCTA镜像的SCP上手动映射FAZ。结果:糖尿病患者中央区(P = 0.04)和下区(P = 0.01)的浅毛细血管丛血管密度(SCPVD)均明显低于对照组。此外,糖尿病患者颞黄斑厚度(MT)和神经节细胞层(GCL)除中央和下黄斑外,其余三个象限均显著减少(P < 0.05)。与对照组相比,糖尿病患者黄斑视网膜上神经纤维层(RNFL)也明显变薄(P = 0.02)。糖尿病患者的中央凹无血管区(FAZ)较大,但差异无统计学意义(P = 0.78)。糖尿病病程与上黄斑VD呈显著高正相关(r = 0.77, P < 0.01)。结论:本研究结果提示糖尿病黄斑在临床视网膜病变发生前,神经节细胞层(GCL)明显变薄,浅毛细血管丛(SCP)血管密度降低。扫描源OCT被证明是检测糖尿病患者这些早期变化的重要工具。
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来源期刊
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Pharmacology, Toxicology and Pharmaceutics-Pharmacology
CiteScore
5.90
自引率
6.10%
发文量
431
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed, open access, online journal. The journal is committed to the rapid publication of the latest laboratory and clinical findings in the fields of diabetes, metabolic syndrome and obesity research. Original research, review, case reports, hypothesis formation, expert opinion and commentaries are all considered for publication.
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