Relevance. The main causes of progressive and often bilateral vision loss in patients with diabetes are diabetic macular edema and ischemic maculopathy (IM). The prevalence and severity of IM in patients with preproliferative stage diabetic retinopathy (DR) is unknown. Purpose of the study. To investigate the prevalence and severity of IM using optical coherence tomography with function of angiography (OCTA) marker assessment in compensated diabetic patients with preproliferative stage DR. Materials and methods. 26 patients (58 [32; 78] years) (44 eyes) were included in the study: 14 men (24 eyes) and 12 women (20 eyes). Each patient had standard ophthalmological examination, optical coherence tomography in angiography (OCTA) mode. The following were used as markers of ischemic maculopathy: density of capillary perfusion and vessels in the superficial capillary plexus in the macular zone (MZ), length of the circumference of the avascular zone, bestcorrected visual acuity (BCVA), retinal thickness in the MZ. All patients were divided into comparison groups according to the IM grade (from 0 to 8) (IM classification based on FAG data but corrected for OCTA, Early Treatment of Diabetic Retinopathy Study protocol. Grading of diabetic macular ischemia according to ETDRS Report No. 11). Results and conclusion. In patients with the preproliferative stage of DR, the mean capillary perfusion density in the MZ was 17.4 [3.8; 29.3] %, vessel density in the MZ of the superficial capillary plexus was 9.6 [2.5; 17.5] %, avascular zone circumference length was 0.25 [0.05; 0.69] μm, BVCA was 0.7 [0.1; 1.0], and retinal thickness in the MZ was 265 [203; 750] μm. The glycated hemoglobin level was 8.1 [6.2;13.2] mmol/l. Level IM - 0 was not detected in the presented sample (group 1, 0 eyes), level IM - 1 was detected in 22 patients (group 2, 36 eyes), and 4 patients (group 3, 8 eyes) had level IM - 2. A statistically significant difference between groups 2 and 3 was found between capillary perfusion density scores (18.4 [5.8; 29.3] % against 6.4 [2.5; 8.7]) % (p<0.001), vessel density in the superficial capillary plexus (10 [2.6; 17.5] % against 12.7 [3.8; 16.7] %) (p<0.01), and avascular circumference length (0.22 [0.05; 0.3] against 0.4 [0.32; 0.7]) μm (p<0.001). Decreased capillary perfusion, decreased vascular density, and increased circumferential length of the avascular zone were present in all patients with preproliferative DR. The presence and severity of IM did not depend on the type of diabetes mellitus and the presence of diabetic macular edema. In the patient sample studied, the degree of IM correlated with vessel density and perfusion in the macular zone. At level IM - 1 and IM - 2, no correlation was found between MCOS and the circumference length of the avascular zone. At level IM - 1 and IM - 2, there was no correlation between BVCA and the length of the avascular zone.
| Mualliflar | Тульцева С.Н., Огнева Т.Р, Патрина Е.А., Шадричев Ф.E. |
|---|---|
| Jurnal | Передовая Офтальмология |
| Nashr sanasi | 2025-05-21 |
| Jild | 11 |
| Son | 5 |
| Betlar | 72-76 |
| DOI | 10.57231/j.ao.2024.11.5.016 |
DOI: 10.57231/j.ao.2024.11.5.016 · Maqolaning asl sahifasi · PDF
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