Optical coherence tomography angiography findings in type 1 diabetes with diabetic retinopathy

Session Details

Session Title: Free Paper Session 19: Vascular Diseases & Diabetic Retinopathy V

Session Date/Time: Saturday 09/09/2017 | 16:30-18:00

Paper Time: 17:36

Venue: Room 120

First Author: : T.Um SOUTH KOREA

Co Author(s): :    Y. Yoon   E. Seo                          

Abstract Details

Purpose:

To investigate the optical coherence tomography angiography (OCT-A) parameters in type 1 diabetes with diabetic retinopathy (DR) and compare with those in type 2 diabetes.

Setting:

Retrospective, observational study in a tertiary referral centre

Methods:

Seventy patients with type 1 diabetes were analyzed in this study. DR was graded as 5 stages by using fluorescein angiography (FA) and fundus exam: no DR, mild non-proliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR (PDR). Patients without macular edema confirmed by spectral domain-optical coherence tomography were finally enrolled. Foveal 3x3 mm2 scan OCT-A images were taken using split-spectrum amplitude decorrelation angiography (SSADA) software algorithm. Image J software was used to calculate foveal avascular zone (FAZ) area (mm2) and vascular density (VD) (%) from both superficial capillary plexus (SCP) and deep capillary plexus (DCP). All parameters were compared using GEE (generalized estimating equation) method with identity link and normal distribution.

Results:

Of 70 patients with type 1 diabetes, 24 patients had no DR, 14 mild NPDR, 7 moderate NPDR, 10 severe NPDR, and 15 PDR. Mean of age, duration of diabetes, glycated haemoglobin A1c (HbA1c), and visual acuity were 27.0±9.5 years, 13.9±7.1 years, 8.1±2.3 % and 0.92±0.13. The duration of diabetes was significantly shorter in no DR group as 7.9±4.7 years (P<0.01), than any other groups (16.4 to 17.4 years). HbA1c was not significantly different among 5 groups (P=0.137). FAZ area (mm2) in SCP and DCP became larger as the stage of DR progressed (no DR, 0.307 and 0.393; mild NPDR, 0.346 and 0.391; moderate NPDR, 0.357 and 0.470; severe NPDR, 0.381 and 0.618; PDR, 0.516 and 0.828, P<0.001 and <0.001). Also, VD (%) in SCP and DCP progressively decreased (no DR, 33.77 and 44.21; mild NPDR, 36.12 and 44.31; moderate NPDR, 32.75 and 39.27; severe NPDR, 30.90 and 36.55; PDR, 27.01 and 24.09, P<0.001 and <0.001). The change in VD over DR progression was significantly bigger in DCP than that in SCP (P=0.005). These findings were similar to type 2 diabetes.

Conclusions:

OCT-A in type 1 diabetes with DR showed the worsening of FAZ area and VD in SCP and DCP as DR progressed. The decrease in VD was more severe in DCP than in SCP.

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