J Korean Ophthalmol Soc > Volume 58(7); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(7):811-817.
DOI: https://doi.org/10.3341/jkos.2017.58.7.811    Published online July 15, 2017.
The Changes of Macular Microvasculature and Related Systemic Parameters in Diabetic Patients without Diabetic Retinopathy.
Sang Wook Choi, Joon Hee Cho, Ha Kyung Kim, So Hyun Bae
Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. sohyun.bae.md@gmail.com
당뇨망막병증을 동반하지 않은 당뇨환자에서 황반부 미세혈관의 변화와 연관된 전신인자 분석
최상욱⋅조준희⋅김하경⋅배소현
한림대학교 의과대학 강남성심병원 안과학교실
Correspondence:  So Hyun Bae,
Email: sohyun.bae.md@gmail.com
Received: 9 March 2017   • Revised: 12 May 2017   • Accepted: 20 June 2017
Abstract
PURPOSE
To investigate the systemic parameters related to changes in the retinal microvasculature using optical coherence tomography angiography (OCTA) in diabetic patients without diabetic retinopathy. METHODS: We retrospectively reviewed the medical records of diabetic patients without diabetic retinopathy. All patients showed normal fundus on dilated fundus examinations. OCTA (DRI OCT Triton, Topcon Corporation, Tokyo, Japan) was performed on a 3 × 3 mm area centered at the fovea. The foveal avascular zone (FAZ) area and vascular density (VD) of the superficial and deep capillary plexus (SCP/DCP) were measured. Multiple regression analysis was conducted to evaluate the relationship between microvascular indexes on OCTA and systemic parameters including sex, age, duration of diabetes mellitus (DM), hemoglobin A1c (HbA1c), total cholesterol, presence of hypertension (HTN) and systolic and diastolic blood pressure (SBP/DBP). RESULTS: A total of 35 eyes of 35 patients were included in this study. The mean age was 55.7 ± 11.6 years, the mean duration of DM was 52.4 ± 88.7 months and the mean HbA1c was 8.8 ± 2.3%. The FAZ area of the DCP increased significantly as the HbA1c level increased (p < 0.001), but the other parameters, i.e., sex, age, duration of DM, total cholesterol, presence of HTN, SBP and DBP, did not exhibit significant relations in the DCP (p = 0.727, 0.280, 0.385, 0.816, 0.206, 0.055 and 0.092, respectively). There were no significant relationships between systemic parameters and the FAZ area in the SCP (p > 0.05). No systemic parameters exhibited significant relationships with VD in either the SCP or the DCP (p > 0.05). CONCLUSIONS: The FAZ area of the DCP detected via OCTA increased as the level of HbA1c increased, although the patients did not show diabetic retinopathy on dilated fundus examinations. Therefore, clinicians should consider this when screening diabetic patients for diabetic retinopathy.
Key Words: Diabetic mellitus;Foveal avascular zone;Optical coherence tomography angiography;Vascular density


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