Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy

BACKGROUND: Diabetic retinopathy (DR) is the leading complication of diabetes mellitus (DM) which is reported to affect more than one-third of the global diabetic population. Optical coherence tomography angiography (OCT-A) can help to reveal early biomarkers of DR to improve current diagnostic appr...

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Main Authors: A. N. Stulova, N. S. Semenova, A. V. Zheleznyakova, V. S. Akopyan, Dmitry V. Lipatov, M. V. Shestakova
Format: Article
Language:English
Published: Endocrinology Research Centre 2021-09-01
Series:Сахарный диабет
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Online Access:https://www.dia-endojournals.ru/jour/article/view/12532
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author A. N. Stulova
N. S. Semenova
A. V. Zheleznyakova
V. S. Akopyan
Dmitry V. Lipatov
M. V. Shestakova
author_facet A. N. Stulova
N. S. Semenova
A. V. Zheleznyakova
V. S. Akopyan
Dmitry V. Lipatov
M. V. Shestakova
author_sort A. N. Stulova
collection DOAJ
description BACKGROUND: Diabetic retinopathy (DR) is the leading complication of diabetes mellitus (DM) which is reported to affect more than one-third of the global diabetic population. Optical coherence tomography angiography (OCT-A) can help to reveal early biomarkers of DR to improve current diagnostic approach.AIMS: To evaluate early visual functions deficiency and OCT-A changes in patients with type 1 DM (T1DM) without clinical signs of DR.MATERIALS AND METHODS. 74 eyes of 40 T1DM patients with no apparent DR and 49 eyes of 28 healthy volunteers were included in the study. The mean duration of DM was 11,7 ± 6,1 years. All participants underwent standard ophthalmological examination, low-luminance visual acuity (LLVA) assessment, 7-field fundus photography, OCT and OCT-A. We analyzed LLVA deficit as a marker of visual function. For OCT-A scans we evaluated foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD) and vessel diameter index (VDI) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP).RESULTS: LLVA deficit was significantly higher in T1DM patients (0,16±0,05 vs 0,10±0,04, p<0,0001). We also detected a significant difference in AI level (11,47 ± 0,24 vs 1,31 ± 0,15, p<0,0001). VD was significantly lower in T1DM patients in SVP (25,37 ± 2,24%, vs 26,67 ± 1,81%, p=0,028) and DCP (17,22 ± 3,10 % vs 18,29 ± 1,95%, p=0,015)CONCLUSIONS: Our results demonstrate early visual functions deficiency and OCT-A changes at the preclinical stage of DR. The prognostic value of these findings will be studied during longitudinal observation.
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spelling doaj-art-edc3a0907db741d882e0d2e3ecb3cb372025-08-20T01:57:08ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782021-09-0124324325010.14341/DM1253210882Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathyA. N. Stulova0N. S. Semenova1A. V. Zheleznyakova2V. S. Akopyan3Dmitry V. Lipatov4M. V. Shestakova5Faculty of Medicine, Lomonosov Moscow State UniversityLomonosov Moscow State UniversityEndocrinology Research CenterLomonosov Moscow State UniversityEndocrinology Research Center; Peoples Friendship University of RussiaEndocrinology Research CenterBACKGROUND: Diabetic retinopathy (DR) is the leading complication of diabetes mellitus (DM) which is reported to affect more than one-third of the global diabetic population. Optical coherence tomography angiography (OCT-A) can help to reveal early biomarkers of DR to improve current diagnostic approach.AIMS: To evaluate early visual functions deficiency and OCT-A changes in patients with type 1 DM (T1DM) without clinical signs of DR.MATERIALS AND METHODS. 74 eyes of 40 T1DM patients with no apparent DR and 49 eyes of 28 healthy volunteers were included in the study. The mean duration of DM was 11,7 ± 6,1 years. All participants underwent standard ophthalmological examination, low-luminance visual acuity (LLVA) assessment, 7-field fundus photography, OCT and OCT-A. We analyzed LLVA deficit as a marker of visual function. For OCT-A scans we evaluated foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD) and vessel diameter index (VDI) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP).RESULTS: LLVA deficit was significantly higher in T1DM patients (0,16±0,05 vs 0,10±0,04, p<0,0001). We also detected a significant difference in AI level (11,47 ± 0,24 vs 1,31 ± 0,15, p<0,0001). VD was significantly lower in T1DM patients in SVP (25,37 ± 2,24%, vs 26,67 ± 1,81%, p=0,028) and DCP (17,22 ± 3,10 % vs 18,29 ± 1,95%, p=0,015)CONCLUSIONS: Our results demonstrate early visual functions deficiency and OCT-A changes at the preclinical stage of DR. The prognostic value of these findings will be studied during longitudinal observation.https://www.dia-endojournals.ru/jour/article/view/12532diabetes mellitusdiabetic retinopathyoptical coherence tomographyretinal vessels
spellingShingle A. N. Stulova
N. S. Semenova
A. V. Zheleznyakova
V. S. Akopyan
Dmitry V. Lipatov
M. V. Shestakova
Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
Сахарный диабет
diabetes mellitus
diabetic retinopathy
optical coherence tomography
retinal vessels
title Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
title_full Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
title_fullStr Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
title_full_unstemmed Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
title_short Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
title_sort early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
topic diabetes mellitus
diabetic retinopathy
optical coherence tomography
retinal vessels
url https://www.dia-endojournals.ru/jour/article/view/12532
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