Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography

Abstract

Background: Timely detection of early microvascular changes in patients with prediabetes could help reduce the likelihood of progression of diabetes-related retinal complications. Aim: To determine early microvascular changes in patients with prediabetes using optical coherence tomography angiography (OCT-A). Methods: In this single-center retrospective case-control study, macular OCT-A images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed in non-diabetic controls, and prediabetic and diabetic subjects. A quantitative analysis was performed using ImageJ software of the foveal avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD), and vascular length density (VLD). Results: A total of 94 eyes of 53 patients were included in this study. The global mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, the mean PD was 0.283\u2009±\u20090.15, 0.186\u2009±\u20090.720, and 0.186\u2009±\u20090.07 in non-diabetic controls, and prediabetic and diabetic groups, respectively. The mean VLD was 8.728\u2009±\u20093.425 in non-diabetic controls, 6.147\u2009±\u20091.399 in prediabetic group, and 6.292\u2009±\u20091.997 in patients with diabetes. The comparison of prediabetic patients and controls shows statistical differences between PD and VLD in both plexus SCP (p\u2009=\u20090.002 and p\u2009=\u20090.001, respectively) and DCP (p\u2009=\u20090.005 and p\u2009=\u20090.002, respectively). The mean area of\u2009FAZ in patients with diabetes and normal individuals was 0.281 and 0.196 mm2, respectively (p\u2009<\u20090.001). AI was higher in the control group (0.87\u2009±\u20090.14) and prediabetic group (0.80\u2009±\u20090.17) compared to diabetic patients (0.64\u2009±\u20090.19). There were no differences in FAZ area and AI between prediabetic and non-diabetic controls. Conclusion: PD and VLD demonstrated to be early microvascular changes in prediabetic patients evaluated by OCT-A. No alterations of FAZ were evidenced in this group.