Diyabetik Retinopatisi Olmayan Tip 1 Diyabet Olgularında Retinal Mikrovasküler Yapıların İncelenmesi

Year 2018, Volume: 18 Issue: 4, 628 - 636, 27.12.2018

Nagihan Uğurlu , Ayşe Güzin Taşlıpınar Fatma Yülek Didem Özdemir Reyhan Ersoy Bekir Çakır

https://doi.org/10.17098/amj.501136

Abstract

Amaç: Sunulan çalışmanın amacı retinopati tespit edilmemiş tip 1 diyabet olgularında, optik koherens

tomografi anjiyografi (OCTA) bulgularının değerlendirilmesidir.

Materyal ve Metot: Çalışmaya 11 tip 1 diyabet olgusunun 17 gözü ve 18 sağlıklı gönüllü olgunun 36 gözü

dahil edildi. Optik koherens tomografi anjiyografi görüntüleri, mikrovasküler değişikliklerin varlığı

açısından değerlendirildi ve yüzeysel kapiller pleksus (SKP) ve derin kapiller pleksus (DKP) seviyelerinde

foveal avasküler zone (FAZ) alanı ve vasküler densite (VD) ölçümleri yapıldı.

Bulgular: Optik Koherens Tomografi Anjiyografi incelemelerinde, 11 tip 1 diyabet olgusunun 7’sinde

mikrovasküler değişiklikler izlendi. Diyabetik grup ve kontrol grubu arasında SKP ve DKP seviyelerinde

yapılan faz ölçümlerinde anlamlı bir fark izlenmedi (sırasıyla p=0,647, p=0,874). Diyabetik grup ve kontrol

grubu arasında SKP ve DKP seviyelerinde yapılan VD ölçümleri arasında da anlamlı bir fark yoktu (p>0,05).

Sonuç: Klinik olarak diyabetik retinopati tanısı almamış diyabetik olgularda, retinal mikrovasküler yapıda

harabiyet gelişebilir. Optik koherens tomografi anjiyografi, erken evrede gelişen mikrovasküler bulguların

tanınmasında faydalı olan, hızlı, girişimsel olmayan ve güvenli bir görüntüleme yöntemidir.

Keywords

Tip 1 diabetes mellitus, diyabetik retinopati, optik koherens tomografi

Evaluation of Retinal Microvascular Structures in Type 1 Diabetic Patients without Diabetic Retinopathy

Abstract

Objectives:
The aim of the present study is to evaluate the optical coherence tomography
angiography (OCTA) images in patients with type 1 diabetes who have not been
diagnosed with retinopathy.

Materials
and Methods: The study included 17 eyes of 11
patients with type 1 diabetes and 36 eyes of 18 healthy volunteers. Optical
coherence tomography angiography images were evaluated for the presence of
microvascular changes and measurement of foveal avascular zone (FAZ) area and
vessel density (VD) measurements in the superficial capillary plexus (SCP) and
deep capillary plexus (DCP) were performed.

Results:
Optical coherence tomography angiography revealed microvascular changes in 7 of
11 type 1 diabetes cases. There was no significant difference between the FAZ
measurements between the diabetic group and the control group at the SCP and
DCP levels (p=0,647, p=0,874 respectively). There was also no significant
difference in VD measurements between the diabetic group and the control group
(p> 0.05).
Conclusion: In diabetic patients who
are not clinically diagnosed with diabetic retinopathy, retinal microvascular
damage may occur. Optical coherence tomography angiography is a rapid,
noninvasive, and safe imaging modality that is useful in the recognition of
microvascular findings that develop at an early stage.

Keywords

Type 1 diabetes mellitus, diabetic retinopathy, optical coherence tomography

References

• 1. Yau JW, Rogers SL, Kawasaki R, et al. Meta-Analysis for Eye Disease (META-EYE) Study Group. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012;35(3):556-64.
• 2. Nentwich MM, Ulbig MW. Diabetic retinopathy-ocular complications of diabetes mellitus. World J Diabetes 2015;6(3):489-99.
• 3. D. A. Antonetti, R. Klein, and T. W. Gardner. Diabetic retinopathy. New England Journal of Medicine 2012;366(13):1227–39.
• 4. Chakrabarti R, Harper CA, Keeffe JE. Diabetic retinopathy management guidelines. Expert Review of Ophthalmology 2012;(7):417-39.
• 5. Yannuzzi LA, Rohrer KT, Tindel LJ, et al. Fluorescein angiography complication survey. Ophthalmology 1986;93(5):611-7.
• 6. Jia YL, Tan O, Tokayer J.ve ark. Split-spectrum amplitude decorrelation angiography with optical coherence tomography. Opt Express 2012;20:4710-25.
• 7. Spaide RF, Fujimoto JG, Waheed NK, Sadda SR, Staurenghi G. Optical coherence tomography angiography. Progress in Retinal and Eye Research 2018;64:1-55.
• 8. Choi W, Waheed NK, Moult EM et al. Ultrahigh Speed Swept Source Optical Coherence Tomography Angiography of Retinal and Choriocapillaris Alterations in Diabetic Patients with and without Retinopathy. Retina 2017;37(1):11-21.
• 9. Carvevali A, Sacconi R, Corbelli E ve ark. Optical coherence tomography angiography analysis of retinal vascular plexuses and choriocapillaris in patients with type 1diabetes without diabetic retinopathy. Acta Diabetol 2017;54(7):695-702.
• 10. Diabetic Retinopathy Study Research Group, “A modification of the Airlie House classification of diabetic retinopathy,” Investigative Ophthalmology and Visual Science 1981;21(1):210–26.
• 11. Coscas F, Sellam A, Glacet-Bernard A.ve ark. Normative Data for Vascular Density in Superficial and Deep Capillary Plexuses of Healthy Adults Assessed by Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci 2016;57(9):211-23. doi: 10.1167/iovs.15-18793.
• 12. Matsunaga D, Yi J, De Koo L, Ameri H, Puliafito CA, Kashani AH. Optical coherence tomography angiography of diabetic retinopathy in human subjects. Ophthalmic Surg Lasers Imaging Retina 2015;46:796-805.
• 13. Hwang TS, Jia Y, Gao SS ve ark. Optical coherence tomography angiography features of diabetic retinopathy. Retina 2015;35:2371-6.
• 14. Ishibazawa A, Nagaoka T, Takahashi Ave ark. Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study. Am J Ophthalmol 2015; 160:35-44.
• 15. F. J. Freiberg, M. Pfau, J. Wonsve ark.Optical coherence tomography angiography of the foveal avascular zone in diabetic retinopathy. Graefe’s Archive for Clinical and Experimental Ophthalmology 2016; 254(6):1051–8.
• 16. Mansour AM, Schachat A, Bodiford G, Haymond R. Foveal avascular zone in diabetes mellitus. Retina1993;13(2):125-8.
• 17. Sim DA, Keane PA, Zarranz-Ventura J,ve ark. The effects of macular ischemia on visual acuity in diabetic retinopathy. Invest Ophthalmol Vis Sci 2013;54(3):2353-60.
• 18. Conrath J, Giorgi R, Raccah D, Ridings B. Foveal avascular zone in diabetic retinopathy: quantitative vs qualitative assessment. Eye 2005;19(3):322-6.
• 19. Takase N, Nozaki M, Kato A ve ark. Enlargement of foveal avascular zone in diabetic eyes evaluated by en face optical coherence tomography angiography. Retina 2015;35(11):2377-83.
• 20. M. M. Goudot, A. Sikorav, O. Semoun et al. Parafoveal OCT angiography features in diabetic patients without clinicaldiabetic retinopathy: a qualitative and quantitative analysis. Journal of Ophthalmology 2017;9:8676091. doi: 10.1155/2017/8676091.
• 21. Goøębiewska J,Olechowski A, Wysocka-Mincewicz M ve ark. Optical coherence tomography angiography vessel density in children with type 1 diabetes. PLoS One 2017;12(10):e0186479. doi: 10.1371/journal.pone.0186479.
• 22. J. Tam, J. A. Martin, and A. Roorda. Noninvasive visualization and analysis of parafoveal capillaries in humans. Investigative Ophthalmology and Visual Science 2010;51(3):1691–8.
• 23. G. Hilmantel, R. A. Applegate, W. A. van Heuvenveark.Entoptic foveal avascular zone measurement and diabetic retinopathy.Optometry and Vision Science Official Publication of the American Academy of Optometry 1999;76(12):826–31.
• 24. G. Di, Y. Weihong, Z. Xiaoveark. A morphological study of the foveal avascular zone in patients with diabetes mellitus using optical coherence tomography angiography. Graefe’s Archive for Clinical and Experimental Ophthalmology 2016;254(5):873–9. 25. Lee J, Rosen R. Optical coherence tomography angiography in diabetes. Curr Diab Rep 2016;16(12):123.
• 26. Mastropasqua R, Toto L, Mastropasqua Aveark.Foveal avascular zone area and parafoveal vessel density measurements in different stages of diabetic retinopathy by optical coherence tomography angiography. Int J Ophthalmol 2017;10(10):1545–55. 27. Samara WA, Shahlaee A, Adam MK ve ark. Quantification of Diabetic Macular Ischemia Using Optical Coherence Tomography Angiography and Its Relationship with Visual Acuity. Ophthalmology 2017;124(2):235-44.