Session Title: Free Paper Session 19: Vascular Diseases & Diabetic Retinopathy V
Session Date/Time: Saturday 09/09/2017 | 16:30-18:00
Paper Time: 16:30
Venue: Room 120
First Author: : G.Tan SINGAPORE
Co Author(s): : D. Ting R. Agrawal N. Sie T. Wong
To evaluate the retinal microvasculature using Optical Coherence Tomography Angiography (OCT-A) in patients with diabetes and the examine the relationship of OCT-A parameters with diabetic retinopathy (DR) and systemic risk factors
A prospective and observational study conducted in the diabetic retina clinics at the Singapore National Eye Centre
50 patients with type 2 diabetes with and without DR (n=100 eyes) were recruited. We examined the retinal microvasculature with swept source OCT-A and a semi-automated software to measure the capillary density index (CDI) and fractal dimension (FD) at superficial (SVP) and deep retinal vascular plexus (DVP). We collected data on patients’ glycated haemoglobin (HbA1c), hypertension, hyperlipidemia, smoking history and renal impairment. The main outcome measures were the CDI and FD at SVP and DVP for each DR severity level and the association of systemic risk factors versus CDI and FD
The mean age and HbA1c of the patients were 59.5 ± 8.9 years and 7.9 ± 1.7%, respectively. 70% were Chinese (n=35) and more than half were male (64%, n=26). The mean CDI decreased from 35.8% to 33.8% at SVP (p<0.001) and 36.1% to 34.5% in DVP (p=0.04) in patients with no DR to PDR; the FD increased from 1.53 to 1.60 (p<0.01) and 1.55 to 1.61 (p=0.02) at SVP and DVP level, respectively. For systemic risk factors, hyperlipidemia (OR: 9.82; 95%CI: 6.92-11.23; p<0.0001), smoking (OR: 8.92, 8.23-12.34, p<0.001) and renal impairment (OR3.7; 1.80-4.81, p=0.05) were associated with reduced CDI while increased HbA1c (>8%) (OR: 8.77; 5.23-10.81, p<0.001) and renal impairment (OR: 10.3, 8.21-11.91, p<0.001) were associated with increased FD.
OCT-A is a novel imaging modality able to quantify the retinal capillary microvasculature in diabetes. It can potentially utilized in interventional trials to non-invasively study the effect of systemic risk factors on the retinal microvasculature. The relevance of these findings relative to visual acuity, however, remains largely unknown at this time.