Evaluation of macular microvascular changes in gestational diabetes mellitus

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.