Clinical Ophthalmology (Oct 2024)

Retinal and Choroidal Vascularization Parameters in Patients with Type 2 Diabetes Without Diabetic Retinopathy

  • Małyszczak A,
  • Przeździecka-Dołyk JW,
  • Szydełko-Paśko U,
  • Misiuk-Hojło M

Journal volume & issue
Vol. Volume 18
pp. 3019 – 3029

Abstract

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Artur Małyszczak,1 Joanna Wiktoria Przeździecka-Dołyk,2 Urszula Szydełko-Paśko,1 Marta Misiuk-Hojło1 1Department and Clinic of Ophthalmology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland; 2Ophthalmology Clinical Center SPEKTRUM, Research and Development Center CREO, Wroclaw, Dolnoslaskie, PolandCorrespondence: Artur Małyszczak, Department and Clinic of Ophthalmology, Wroclaw Medical University, Borowska 213, Wrocław, Dolnoslaskie, 50-556, Poland, Tel +71 736 43 00, Email [email protected]: The purpose of this study was to evaluate retinal and choroidal vascularization parameters in patients with type 2 diabetes mellitus (DM), without diabetic retinopathy (DR), and to compare them to healthy controls.Patients and methods: Seventy-four eyes from 74 patients (40 eyes in the DM group and 34 eyes in the control group) were included in the study. Optical coherence tomography angiography RTVue XR Avanti was used to obtain 3× 3mm scans of the macula. The choroidal vascularity index (CVI), superficial and deep capillary plexus vascular densities (SCP and DCP, respectively), and choroidal thickness (CT) were measured.Results: In the diabetic group, SCP was lower in the superior and nasal segments (48.68 vs 50.62, p=0.02; 45.50 vs 48.82, p=0.02, respectively). The DCP did not differ between the groups. CVI was significantly lower in the study group in all measured segments, including central and parafoveal (31.73 vs 48.86 and 50.32 vs 59.58, p< 0.001, respectively). CT was larger in the study group only at the center of the macula (281.89μm vs 268.37μm p< 0.001) and in the inferior segment (337.47μm vs 329.40μm, p< 0.001). In the multivariate regression, clinical and vascularization parameters affecting CVI and CT were analyzed after adjusting for age and sex. Decreased central CVI was associated with the presence of DM, lower central SCP, and bigger foveal avascular zone area (b=− 0.68, b=0.47, b=− 0.21). Parafoveal CVI was also negatively affected by DM (b= − 0.46) and positively by parafoveal SCP (b= 0.44). Increased central CT was found to be positively associated with higher central SCP (b=0.48) and male sex (b=0.20).Conclusion: The results of our study confirmed a reduction of SCP and CVI in diabetic patients without DR. DM and SCP are age and sex independent parameters affecting CVI. Central CT is affected by SCP and sex, rather than the presence of diabetes.Keywords: choroidal vascularity index, choroidal thickness, OCTA, diabetes

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