Optical coherence tomography angiography analysis of retinal vascular plexuses and choriocapillaris in patients with type 1 diabetes without diabetic retinopathy

• Published in: Acta diabetologica Vol. 54; no. 7; pp. 695 - 702
• Main Authors: Carnevali, Adriano, Sacconi, Riccardo, Corbelli, Eleonora, Tomasso, Livia, Querques, Lea, Zerbini, Gianpaolo, Scorcia, Vincenzo, Bandello, Francesco, Querques, Giuseppe
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.07.2017; Springer Nature B.V
• Subjects: Adolescent; Adult; Angiography; Angiography - methods; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - pathology; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Eye diseases; Female; Fluorescein Angiography; Fundus Oculi; Humans; Internal Medicine; Male; Medical imaging; Medicine; Medicine & Public Health; Metabolic Diseases; Microvasculature; Original Article; Predictive Value of Tests; Retina; Retina - diagnostic imaging; Retinal Ganglion Cells - pathology; Retinal Ganglion Cells - ultrastructure; Retinal Neurons - pathology; Retinal Neurons - ultrastructure; Retinal Vessels - diagnostic imaging; Retinopathy; Single-cell protein; Tomography; Tomography, Optical Coherence; Young Adult; Diabetic retinopathy; Retinal nerve fiber layer; Optical coherence tomography angiography; Ganglion cell layer; Retinal imaging
• DOI: 10.1007/s00592-017-0996-8
• ISSN: 0940-5429; 1432-5233

Aims To analyze retinal vascular plexuses and choriocapillaris by optical coherence tomography angiography (OCT-A) and retinal nerve fiber layer and ganglion cell layer (GCL) by structural optical coherence tomography (OCT) in patients with type 1 diabetes mellitus (T1DM) without diabetic retinopathy (DR). Methods A total of 25 eyes of 25 consecutive T1DM patients without signs of DR were prospectively recruited and compared to 25 healthy subjects (control eyes). All patients underwent OCT-A (CIRRUS HD-OCT model 5000, Carl Zeiss Meditec, Dublin, CA) and structural OCT. Qualitative and quantitative analyses with vessel density were performed on OCT-A images in the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris for all patients. Results By means of OCT-A, a rarefaction of the perifoveal capillary network in SCP was detected in 7 out of 25 eyes. No significant difference was found in FAZ area of both SCP and DCP comparing diabetic and control groups. By analyzing the DCP, diabetic eyes revealed a significant decreased vessel density compared to control eyes [0.464 ± 0.016 and 0.477 ± 0.014, respectively ( p  = 0.005)]. Instead, no significant difference was found in the vessel density of all-retina plexus, SCP and choriocapillaris. By RFNL and GCL thickness analysis, no significant differences were disclosed between diabetics and healthy subjects. Conclusions We demonstrated the ability of OCT-A to disclose early vascular alterations in patients with T1DM diagnosed as without any signs of DR on the basis of fundus biomicroscopy. Our results also suggest that microvascular changes could precede detectable damage of diabetic neuroretinopathy.