Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography

Aim – to examine the impact of metabolic disorders on retinal blood flow in patients with age-related macular degeneration (AMD) and diabetes mellitus using optical coherence tomography angiography (OCT-A). Materials and methods. The study included 98 eyes (62 patients) with early dry AMD. OCT-A...

Full description

Saved in:
Bibliographic Details
Main Authors: N. S. Lutsenko, T. S. Kyrylova
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2025-02-01
Series:Zaporožskij Medicinskij Žurnal
Subjects:
Online Access:http://zmj.zsmu.edu.ua/article/view/313930/313425
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850245286620823552
author N. S. Lutsenko
T. S. Kyrylova
author_facet N. S. Lutsenko
T. S. Kyrylova
author_sort N. S. Lutsenko
collection DOAJ
description Aim – to examine the impact of metabolic disorders on retinal blood flow in patients with age-related macular degeneration (AMD) and diabetes mellitus using optical coherence tomography angiography (OCT-A). Materials and methods. The study included 98 eyes (62 patients) with early dry AMD. OCT-A examinations assessed retinal blood flow density in different areas with manual segmentation to define superficial (SCP), intermediate (ICP), and deep (DCP) capillary plexuses. Laboratory tests evaluated glucose and lipid profiles and homocysteine. Morphometric measurements were also conducted: waist circumference (WC) and body mass index (BMI). Patients were grouped based on carbohydrate metabolism impairment: Group 1 (no abnormalities), Group 2 (insulin resistance (IR)), and Group 3 (type 2 diabetes mellitus (DM)). Results. The study has identified higher glucose levels in the type 2 DM group (10.67 ± 5.11 mmol/L, p = 0.05) and elevated HOMA index in both IR (4.48 ± 2.17, p = 0.03) and diabetes groups (4.89 ± 1.13, p = 0.04). Homocysteine levels were lower in DM patients (6.36 ± 2.57 µMol/L, p = 0.02). No significant differences have been found in lipid profiles or morphometric parameters (p > 0.05). WC and BMI were strongly correlated with reduced blood flow in the SCP middle / far periphery (r = -0.747, p = 0.001). Elevated blood glucose (r = -0.606, p = 0.017) and HOMA index (r = -0.664, p = 0.013) were associated with reduced macular blood flow in the SCP macular region. Triglycerides have shown the most significant negative effect on the blood flow, especially in the SCP macular area (r = -0.883, p = 0.0001). Homocysteine and cholesterol have also been linked to reduced blood flow in the DCP, while high-density lipoprotein has been found to be protective. Conclusions. The results suggest that glucose metabolism abnormalities, IR, and elevated lipid and homocysteine levels significantly impair retinal blood flow, particularly in the macula and peripheral regions, emphasizing the importance of metabolic control in patients with AMD and DM.
format Article
id doaj-art-05dae91e2e2e483996b2828b38e4de9b
institution OA Journals
issn 2306-4145
2310-1210
language English
publishDate 2025-02-01
publisher Zaporizhzhia State Medical and Pharmaceutical University
record_format Article
series Zaporožskij Medicinskij Žurnal
spelling doaj-art-05dae91e2e2e483996b2828b38e4de9b2025-08-20T01:59:30ZengZaporizhzhia State Medical and Pharmaceutical UniversityZaporožskij Medicinskij Žurnal2306-41452310-12102025-02-012713843https://doi.org/10.14739/2310-1210.2025.1.313930Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiographyN. S. Lutsenko0https://orcid.org/0000-0001-9433-7568T. S. Kyrylova1https://orcid.org/0000-0003-1435-6836Zaporizhzhia State Medical and Pharmaceutical University, UkraineZaporizhzhia State Medical and Pharmaceutical University, UkraineAim – to examine the impact of metabolic disorders on retinal blood flow in patients with age-related macular degeneration (AMD) and diabetes mellitus using optical coherence tomography angiography (OCT-A). Materials and methods. The study included 98 eyes (62 patients) with early dry AMD. OCT-A examinations assessed retinal blood flow density in different areas with manual segmentation to define superficial (SCP), intermediate (ICP), and deep (DCP) capillary plexuses. Laboratory tests evaluated glucose and lipid profiles and homocysteine. Morphometric measurements were also conducted: waist circumference (WC) and body mass index (BMI). Patients were grouped based on carbohydrate metabolism impairment: Group 1 (no abnormalities), Group 2 (insulin resistance (IR)), and Group 3 (type 2 diabetes mellitus (DM)). Results. The study has identified higher glucose levels in the type 2 DM group (10.67 ± 5.11 mmol/L, p = 0.05) and elevated HOMA index in both IR (4.48 ± 2.17, p = 0.03) and diabetes groups (4.89 ± 1.13, p = 0.04). Homocysteine levels were lower in DM patients (6.36 ± 2.57 µMol/L, p = 0.02). No significant differences have been found in lipid profiles or morphometric parameters (p > 0.05). WC and BMI were strongly correlated with reduced blood flow in the SCP middle / far periphery (r = -0.747, p = 0.001). Elevated blood glucose (r = -0.606, p = 0.017) and HOMA index (r = -0.664, p = 0.013) were associated with reduced macular blood flow in the SCP macular region. Triglycerides have shown the most significant negative effect on the blood flow, especially in the SCP macular area (r = -0.883, p = 0.0001). Homocysteine and cholesterol have also been linked to reduced blood flow in the DCP, while high-density lipoprotein has been found to be protective. Conclusions. The results suggest that glucose metabolism abnormalities, IR, and elevated lipid and homocysteine levels significantly impair retinal blood flow, particularly in the macula and peripheral regions, emphasizing the importance of metabolic control in patients with AMD and DM.http://zmj.zsmu.edu.ua/article/view/313930/313425age-related macular degenerationinsulin resistancediabetesmetabolic disordersmetabolic syndromeretinal plexusesblood flow densityoptical coherence tomography angiography
spellingShingle N. S. Lutsenko
T. S. Kyrylova
Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography
Zaporožskij Medicinskij Žurnal
age-related macular degeneration
insulin resistance
diabetes
metabolic disorders
metabolic syndrome
retinal plexuses
blood flow density
optical coherence tomography angiography
title Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography
title_full Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography
title_fullStr Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography
title_full_unstemmed Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography
title_short Metabolic disorders and their impact on retinal blood flow in patients with age-related macular degeneration and diabetes mellitus: data from optical coherence tomography angiography
title_sort metabolic disorders and their impact on retinal blood flow in patients with age related macular degeneration and diabetes mellitus data from optical coherence tomography angiography
topic age-related macular degeneration
insulin resistance
diabetes
metabolic disorders
metabolic syndrome
retinal plexuses
blood flow density
optical coherence tomography angiography
url http://zmj.zsmu.edu.ua/article/view/313930/313425
work_keys_str_mv AT nslutsenko metabolicdisordersandtheirimpactonretinalbloodflowinpatientswithagerelatedmaculardegenerationanddiabetesmellitusdatafromopticalcoherencetomographyangiography
AT tskyrylova metabolicdisordersandtheirimpactonretinalbloodflowinpatientswithagerelatedmaculardegenerationanddiabetesmellitusdatafromopticalcoherencetomographyangiography