Endocrine Abstracts

Introduction: Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus, leading to visual impairment among individuals of working age. Optical coherence tomography angiography (OCTA) has been developed to visualize the retinal microvasculature and choriocapillaris based on the motion contrast of circulating blood cells.

Purpose: To investigate the qualitative microvascular changes in retinal vascular plexuses and choriocapillaris (CC) in patients with type 2 diabetes mellitus (DM2) without DR using swept-source optical coherence tomography angiography (SS-OCTA). hanges in retinal vascular plexuses and choriocapillaris in patients with type 2 diabetes mellitus (DM2) without diabetic retinopathy (DR)

Methods: An OCTA (DRI OCT Triton; Topcon Corp, Japan) system was used to collect 3×3-mm macular scans from diabetic patients without clinical evidence of diabetic retinopathy. We conducted a descriptive qualitative analysis of foveal and extrafoveal microcirculation at the level of the superficial (SCP), the deep (DCP) retinal capillary plexus and the choriocapillaris (CC) to identify microvascular changes in diabetic eyes without clinically detectable retinopathy.

Results: Thirty eyes from 15 diabetic patients without clinical evidence of retinopathy were analyzed. Microaneurysms seen in OCTA but not in fundus examination were found in 4 eyes. The presence of breaks in the perifoveal anastomotic circle is observed at the level of the SCP in 10 eyes. Within the DCP, there are vascular dilations in 8 eyes with an enlargement of the anastomotic circle in 10 eyes, which appears larger compared to its size in the SCP. Areas of hypo-perfusion are noted as hypo-signal zones within the CC in 8 eyes.

Conclusion: DM2 patients without DR have SCP, DCP and CC qualitative impairment. These study highlight that OCT A can identify preclinical microvascular abnormalities preceding the onset of clinically detectable DR, serving as potential biomarkers for the early detection of DR.