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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Autores principales:	A. N. Stulova, N. S. Semenova, A. V. Zheleznyakova, V. S. Akopyan, Dmitry V. Lipatov, M. V. Shestakova
Formato:	article
Lenguaje:	EN RU
Publicado:	Endocrinology Research Centre 2021
Materias:	diabetes mellitus diabetic retinopathy optical coherence tomography retinal vessels Nutritional diseases. Deficiency diseases RC620-627
Acceso en línea:	https://doaj.org/article/edc3a0907db741d882e0d2e3ecb3cb37
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spelling	oai:doaj.org-article:edc3a0907db741d882e0d2e3ecb3cb372021-11-14T09:00:23ZEarly functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy2072-03512072-037810.14341/DM12532https://doaj.org/article/edc3a0907db741d882e0d2e3ecb3cb372021-09-01T00:00:00Zhttps://www.dia-endojournals.ru/jour/article/view/12532https://doaj.org/toc/2072-0351https://doaj.org/toc/2072-0378BACKGROUND: 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.A. N. StulovaN. S. SemenovaA. V. ZheleznyakovaV. S. AkopyanDmitry V. LipatovM. V. ShestakovaEndocrinology Research Centrearticlediabetes mellitusdiabetic retinopathyoptical coherence tomographyretinal vesselsNutritional diseases. Deficiency diseasesRC620-627ENRUСахарный диабет, Vol 24, Iss 3, Pp 243-250 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	diabetes mellitus diabetic retinopathy optical coherence tomography retinal vessels Nutritional diseases. Deficiency diseases RC620-627
spellingShingle	diabetes mellitus diabetic retinopathy optical coherence tomography retinal vessels Nutritional diseases. Deficiency diseases RC620-627 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
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.
format	article
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
title	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_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_sort	early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy
publisher	Endocrinology Research Centre
publishDate	2021
url	https://doaj.org/article/edc3a0907db741d882e0d2e3ecb3cb37
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Early functional and microcirculatory changes in patients with type 1 diabetes mellitus and no apparent diabetic retinopathy

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