期刊
GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
卷 258, 期 3, 页码 513-520出版社
SPRINGER
DOI: 10.1007/s00417-019-04590-x
关键词
Diabetic retinopathy; Diabetes mellitus; Retinal vascular changes; Optical coherence tomographic angiography; Kailuan study
资金
- Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support [ZYLX201307]
- National Natural Science Foundation of China [81272981]
- Beijing Natural Science Foundation [7151003]
- Advanced Health Care Professionals Development Project of Beijing Municipal Health Bureau [2014-2-003]
- priming scientific research foundation for the junior research in Beijing Tongren Hospital Capital Medical University [2017-YJJ-ZZL-009, 2018-YJJ-ZZL-046]
- Beijing Municipal Administration of Hospitals Incubating Program [PX2019008]
Purpose To investigate microvascular abnormalities in diabetic patients without conventional clinical signs of diabetic retinopathy (DR). Methods In this cross-sectional observational cohort study, the study group included randomly chosen participants of a community-based cohort with diabetes type 2 without DR, and the control group consisted of non-diabetic individuals from a population-based study. All participants underwent optical coherence tomographic angiography (OCTA). Results Upon OCTA, 118 (40.4%) eyes of the study group (n = 292 eyes) showed microvascular abnormalities including foveal avascular zone erosion (95 (32.5%) eyes), non-perfusion areas in the superficial and deep retinal layers (39 (13.4%) eyes and 19 (6.5%) eyes, respectively), and microaneurysms in the superficial and deep retinal layers (22 (7.5%) eyes and 31 (10.6%) eyes, resp.). None of these abnormalities was detected in the control group (n = 80). The study group showed a lower vessel density in the superficial retinal vascular layer in all regions except for the foveal region (P < 0.001), and higher vessel density in the parafoveal region in the deep retinal vascular layer (P = 0.01). Higher diabetes prevalence was associated with lower superficial retinal vascular density (P = 0.005) in multivariable analysis. A lower radial peripapillary capillary flow density was correlated (regression coefficient r, 0.62) with higher fasting blood concentration of glucose (P < 0.001) in multivariable analysis. Conclusions OCTA revealed microvascular abnormalities in 40% of eyes of diabetic patients without ophthalmoscopically detectable diabetic fundus changes in a community-based population. The early stage of DR may be re-defined upon OCTA.
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