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Foveal avascular zone analysis by optical coherence tomography angiography in patients with type 1 and 2 diabetes and without clinical signs of diabetic retinopathy

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Abstract

Purpose

To analyze the early macular microvascular alterations in patients with type 1 and 2 diabetes mellitus (DM) without diabetic retinopathy (DR), using optical coherence tomography angiography (OCT-A), and compare these with nondiabetic patients.

Methods

This prospective study involved 93 patients with type 1 diabetes (DM1), 104 patients with type 2 diabetes (DM2) without signs of DR, and 71 healthy subjects for the control group. The foveal avascular zone (FAZ) area and the vessel density (VD) at the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were evaluated.

Results

The SCP and DCP FAZ areas were significantly larger in the DM1 group in comparison with the controls (p = .001), while no significant differences were observed between the DM2 group and the healthy control group (p = .12). Additionally, no significant differences in FAZ area were found between the DM1 and DM2 groups (p = .26). The VD was significantly reduced in DM1 and DM2 groups compared to controls. A direct correlation was found between the duration of diabetes and SCP FAZ area (r = 0.44; R2 = 0.19; p = .0001). Statistically significant differences in the FAZ area at SCP and DCP were observed when comparing patients with a diabetes duration > 10 years and < 10 years in the DM2 group (p = .0001, respectively) and only in the FAZ area at the DCP in the DM1 group (p = .0001).

Conclusion

Diabetic patients without DR demonstrate early microvascular alteration in the macular area on OCT-A, which is more pronounced in type I DM, and correlates with the duration of the disease.

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Data availability

All data are available, please contact the corresponding author.

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Funding

No financial support was given to the present study.

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Authors and Affiliations

  1. Biomedical, Dental and Morphological and Functional Images Sciences, Department of Ophthalmology, University of Messina, 98122, Messina, Italy

    Giovanni William Oliverio, Ida Ceravolo & Costantino John Trombetta

  2. Glangwili General Hospital Carmarthen, Carmarthen, SA31 2AF, Wales, UK

    Ahsan Bhatti

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  1. Giovanni William Oliverio
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  2. Ida Ceravolo
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  4. Costantino John Trombetta
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Ceravolo I and Oliverio GW. The first draft of the manuscript was written by Oliverio GW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Giovanni William Oliverio.

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The authors declare that they have no conflict of interest.

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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. This study was approved by the institutional Board Review of the University of Messina (Protocol Number 78/18).

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Oliverio, G.W., Ceravolo, I., Bhatti, A. et al. Foveal avascular zone analysis by optical coherence tomography angiography in patients with type 1 and 2 diabetes and without clinical signs of diabetic retinopathy. Int Ophthalmol 41, 649–658 (2021). https://doi.org/10.1007/s10792-020-01621-z

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  • DOI: https://doi.org/10.1007/s10792-020-01621-z

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