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      Early changes to retinal structure in patients with diabetic retinopathy as determined by ultrawide swept-source optical coherence tomography-angiography

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          Abstract

          Purpose

          To investigate retinal vascular changes in patients with diabetic retinopathy (DR) using the newly developed ultrawide rapid scanning swept-source optical coherence tomography angiography (SS-OCTA) device.

          Methods

          This cross-sectional, observational study enrolled 24 patients (47 eyes) with DR, 45 patients (87 eyes) with diabetes mellitus (DM) without DR, and 36 control subjects (71 eyes). All subjects underwent 24 × 20 mm SS-OCTA examination. Vascular density (VD) and the thickness of the central macula (CM; 1 mm diameter) and temporal fan-shaped areas of 1–3 mm (T3), 3–6 mm (T6), 6–11 mm (T11), 11–16 mm (T16), and 16–21 mm (T21) were compared among groups. The VD and the thicknesses of the superficial vascular complex (SVC) and deep vascular complex (DVC) were analyzed separately. The predictive values of VD and thickness changes in DM and DR patients were evaluated by receiver operating characteristic (ROC) curve analysis.

          Results

          The average VDs of the SVC in the CM and the T3, T6, T11, T16, and T21 areas were significantly lower in the DR than in the control group, whereas only the average VD of the SVC in the T21 area was significantly lower in the DM group. The average VD of the DVC in the CM was significantly increased in the DR group, whereas the average VDs of the DVC in the CM and T21 area were significantly decreased in the DM group. Evaluation of the DR group showed significant increases in the thicknesses of SVC-nourishing segments in the CM and T3, T6, and T11 areas and significant increases in the thicknesses of DVC-nourishing segments in the CM and T3 and T6 areas. In contrast, none of these parameters showed significant changes in the DM group. ROC curve analysis showed that the average VD of the SVC in the CM, T3, and T21 had better ability to predict DR, with areas under the ROC curves (AUCs) of 0.8608, 0.8505, and 0.8353, respectively. The average VD of the DVC in the CM was also predictive of DR, with an AUC of 0.8407.

          Conclusions

          The newly developed ultrawide SS-OCTA device was better able to reveal early peripheral retinal vascular changes than traditional devices.

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          Most cited references35

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          IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045

          Hong Sun, Pouya Saeedi, Suvi Karuranga … (2022)
          To provide global, regional, and country-level estimates of diabetes prevalence and health expenditures for 2021 and projections for 2045.
          Article 0 comments Cited 1884 times – based on 0 reviews     Review now
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            Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography.

            Richard Spaide, James Klancnik, Michael J Cooney (2015)
            The retinal vasculature is involved in many ocular diseases that cause visual loss. Although fluorescein angiography is the criterion standard for evaluating the retina vasculature, it has risks of adverse effects and known defects in imaging all the layers of the retinal vasculature. Optical coherence tomography (OCT) angiography can image vessels based on flow characteristics and may provide improved information.
            Article 0 comments Cited 263 times – based on 0 reviews     Review now
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              DETECTION OF MICROVASCULAR CHANGES IN EYES OF PATIENTS WITH DIABETES BUT NOT CLINICAL DIABETIC RETINOPATHY USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.

              Talisa de Carlo, Adam T Chin, Marco A Bonini Filho … (2015)
              To evaluate the ability of optical coherence tomography angiography to detect early microvascular changes in eyes of diabetic individuals without clinical retinopathy.
              Article 0 comments Cited 75 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Endocrinol (Lausanne)
                Journal ID (iso-abbrev): Front Endocrinol (Lausanne)
                Journal ID (publisher-id): Front. Endocrinol.
                Title: Frontiers in Endocrinology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-2392
                Publication date (Electronic): 08 May 2023
                Publication date Collection: 2023
                Volume: 14
                Electronic Location Identifier: 1143535
                Affiliations
                [1] 1 Department of Ophthalmology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China , Chengdu, China
                [2] 2 Department of Ophthalmology, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital , Chengdu, China
                [3] 3 Jinniu Maternity and Child Health Hospital of Chengdu, Department of Child Healthcare , Chengdu, China
                [4] 4 Department of Pulmonary and Critical Care Medicine, Enyang District People’s Hospital of Bazhong , Bazhong, Sichuan, China
                Author notes

                Edited by: Mohd Imtiaz Nawaz, King Saud University, Saudi Arabia

                Reviewed by: Sudhanshu Kumar Bharti, Patna University, India; Juan Wang, Tongji University, China

                †These authors have contributed equally to this work and share first authorship

                Article
                DOI: 10.3389/fendo.2023.1143535
                PMC ID: 10200911
                SO-VID: 4088703e-a3ee-4fd5-829b-44a1831eab79
                Copyright © Copyright © 2023 Zeng, Liu, Li, Wei, Mao, Liu, Chen, Liu, Chen, Yang, Liu, Qiao, Zhang, Li, Dong and Zhong
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 13 January 2023
                Date accepted : 12 April 2023
                Page count
                Figures: 5, Tables: 2, Equations: 0, References: 35, Pages: 9, Words: 4342
                Funding
                Funded by: Sichuan Province Science and Technology Support Program , doi 10.13039/100012542;
                Award ID: 2021ZYD0108
                Funded by: Natural Science Foundation of Sichuan Province , doi 10.13039/501100018542;
                Award ID: 2022NSFSC1352
                Funded by: Sichuan Province Science and Technology Support Program , doi 10.13039/100012542;
                Award ID: 2017YSKY0001, 2021YJ0234
                Funded by: Health and Family Planning Commission of Sichuan Province , doi 10.13039/501100010032;
                Award ID: 16PJ454
                This study was supported by the Sichuan Province Central Government Guides Local Science and Technology Development Special Project (2021ZYD0108), the Natural Science Foundation of Sichuan Province (2022NSFSC1352), the Science & Technology Department of Sichuan Province (2017YSKY0001, 2021YJ0234), the medical science and technology project of Health and Family Commission of Sichuan Province (16PJ454), the Sichuan Provincial People’s Hospital (2021QN13) and the 2021 open project of Sichuan Provincial Key Laboratory for Human Disease Genetics Research (2021kflx008).
                Categories
                Subject: Endocrinology
                Subject: Original Research
                Custom metadata
                section-at-acceptance Clinical Diabetes

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: vascular density (vd),thickness,diabetes mellitus,diabetic retinopathy,ss-octa,peripheral retina
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: vascular density (vd), thickness, diabetes mellitus, diabetic retinopathy, ss-octa, peripheral retina

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