Evaluation of macular microvascular changes in gestational diabetes mellitus

IF 2.6 3区医学 Q2 ONCOLOGY

Photodiagnosis and Photodynamic Therapy Pub Date : 2025-08-21 DOI:10.1016/j.pdpdt.2025.104770

Mukaddes Damla Ciftci , Filiz Afrashi , Cumali Degirmenci , Didem Gul Saritas , Fuat Akercan

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Abstract

Background

To evaluate retinal microvascular changes in GDM patients in the prepartum and postpartum periods with optical coherence tomography angiography (OCTA).

Methods

Forty-nine GDM patients (Group 1) and 39 healthy pregnant women (Group 2) were included in this study. Vascular density, foveal avascular zone (FAZ) area, and flow area were measured by OCTA. Twenty-four volunteers from Group 1 and 11 volunteers from Group 2 were re-evaluated after the 6th postpartum week.

Results

The mean age was 32.02±4.65 (23–42) in Group 1 and 30±5.66 (18–42) in Group 2. The average gestational week was 32.08±2.92 (23–38) and 31.31±3.51 (24–37) weeks in Group 1 and 2, respectively. Deep capillary plexus vascular density (DCP-VD) was found to be significantly lower in the GDM group (58.38±5.5 % and 60.52±3.75 %; p = 0.01). In the postpartum period, significant increase was observed in both superficial capillary plexus vascular density (SCP-VD) and DCP-VD in only the Group 1 when compared to the prepartum period, overtime (54.53±1.93 % and 53.04±2.83 %; 60.17±4.28 % and 58.38±5.5 %; p < 0.001 and p = 0.018, respectively). When the correlation between the data obtained from OCTA and HbA1c values of a total of 88 volunteers in Group 1 and Group 2 was evaluated, a negative correlation was detected between choriocapillaris flow measurements and HbA1c values in the prepartum period (p = 0.05, ϱ=-0.22).

Conclusion

DCP-VD in GDM patients was lower than healthy pregnant women. It was shown that vascular density increases in both deep and superficial capillary plexus with the establishment of postpartum normoglycemia.

Abstract Image

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妊娠期糖尿病黄斑微血管变化的评价。

背景：应用光学相干断层扫描血管造影（OCTA）评价GDM患者术前和产后视网膜微血管的变化。方法：选取49例GDM患者（第一组）和39例健康孕妇（第二组）作为研究对象。OCTA测量血管密度、中央凹无血管区（FAZ）面积、血流面积。在产后6周后，对1组24名、2组11名志愿者进行重新评估。结果：1组患者平均年龄32.02±4.65（23-42）岁，2组患者平均年龄30±5.66（18-42）岁。1组和2组平均妊娠周分别为32.08±2.92（23-38）周和31.31±3.51（24-37）周。GDM组深毛细血管丛血管密度（DCP-VD）明显降低，分别为58.38±5.5%和60.52±3.75%,p=0.01。产后只有1组患者的浅毛细血管丛血管密度（SCP-VD）和DCP-VD较孕前、产后显著增高（分别为54.53±1.93%和53.04±2.83%;60.17±4.28%和58.38±5.5%）。结论：GDM患者的DCP-VD低于健康孕妇。结果表明，随着产后血糖恢复正常，深、浅毛细血管丛血管密度均增加。

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来源期刊

Photodiagnosis and Photodynamic Therapy ONCOLOGY-

CiteScore

5.80

自引率

24.20%

发文量

509

审稿时长

50 days

期刊介绍： Photodiagnosis and Photodynamic Therapy is an international journal for the dissemination of scientific knowledge and clinical developments of Photodiagnosis and Photodynamic Therapy in all medical specialties. The journal publishes original articles, review articles, case presentations, "how-to-do-it" articles, Letters to the Editor, short communications and relevant images with short descriptions. All submitted material is subject to a strict peer-review process.