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Optical coherence tomography angiography analysis of retinal vascular plexuses and choriocapillaris in patients with type 1 diabetes without diabetic retinopathy

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Abstract

Aims

To analyze retinal vascular plexuses and choriocapillaris by optical coherence tomography angiography (OCT-A) and retinal nerve fiber layer and ganglion cell layer (GCL) by structural optical coherence tomography (OCT) in patients with type 1 diabetes mellitus (T1DM) without diabetic retinopathy (DR).

Methods

A total of 25 eyes of 25 consecutive T1DM patients without signs of DR were prospectively recruited and compared to 25 healthy subjects (control eyes). All patients underwent OCT-A (CIRRUS HD-OCT model 5000, Carl Zeiss Meditec, Dublin, CA) and structural OCT. Qualitative and quantitative analyses with vessel density were performed on OCT-A images in the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris for all patients.

Results

By means of OCT-A, a rarefaction of the perifoveal capillary network in SCP was detected in 7 out of 25 eyes. No significant difference was found in FAZ area of both SCP and DCP comparing diabetic and control groups. By analyzing the DCP, diabetic eyes revealed a significant decreased vessel density compared to control eyes [0.464 ± 0.016 and 0.477 ± 0.014, respectively (p = 0.005)]. Instead, no significant difference was found in the vessel density of all-retina plexus, SCP and choriocapillaris. By RFNL and GCL thickness analysis, no significant differences were disclosed between diabetics and healthy subjects.

Conclusions

We demonstrated the ability of OCT-A to disclose early vascular alterations in patients with T1DM diagnosed as without any signs of DR on the basis of fundus biomicroscopy. Our results also suggest that microvascular changes could precede detectable damage of diabetic neuroretinopathy.

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Authors and Affiliations

  1. Department of Ophthalmology, University Vita-Salute, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy

    Adriano Carnevali, Riccardo Sacconi, Eleonora Corbelli, Livia Tomasso, Lea Querques, Francesco Bandello & Giuseppe Querques

  2. Department of Ophthalmology, University of “Magna Graecia”, Catanzaro, Italy

    Adriano Carnevali & Vincenzo Scorcia

  3. Department of Ophthalmology, University of Verona, University Hospital of Verona, Verona, Italy

    Riccardo Sacconi

  4. Complications of Diabetes Unit, Division of Metabolic and Cardiovascular Sciences, San Raffaele Scientific Institute, Milan, Italy

    Gianpaolo Zerbini

Authors
  1. Adriano Carnevali
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  2. Riccardo Sacconi
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  3. Eleonora Corbelli
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  4. Livia Tomasso
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  5. Lea Querques
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  6. Gianpaolo Zerbini
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  7. Vincenzo Scorcia
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  8. Francesco Bandello
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  9. Giuseppe Querques
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Corresponding author

Correspondence to Giuseppe Querques.

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Conflict of interest

The authors declare that they have no conflict of interest.

Financial disclosures

Adriano Carnevali, Riccardo Sacconi, Eleonora Corbelli, Lea Querques, Gianpaolo Zerbini, Vincenzo Scorcia, Francesco Bandello, Giuseppe Querques: none.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

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Carnevali, A., Sacconi, R., Corbelli, E. et al. Optical coherence tomography angiography analysis of retinal vascular plexuses and choriocapillaris in patients with type 1 diabetes without diabetic retinopathy. Acta Diabetol 54, 695–702 (2017). https://doi.org/10.1007/s00592-017-0996-8

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  • DOI: https://doi.org/10.1007/s00592-017-0996-8

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