Macular perfusion alterations in people with recent-onset diabetes and novel diabetes subtypes
Authors' conclusion
Type 2 diabetes already reduces macular perfusion SCP at time of clinical diagnosis, while long-standing diabetes affects both SCP and DCP. The FAZ of the SCP and the CC FD are early indicators of diabetic alterations, with more pronounced changes observed in type 2 diabetes. Microaneurysms in the macular plexus are associated with a decrease of ganglion cell layer and inner plexiform layer. Subclinical microangiopathy occurs prior to manifestation of diabetic retinopathy, disease-related visual acuity impairment or inner retinal layer thinning.
Study context
- Population
- Individuals with recent-onset T1D or T2D from the German Diabetes Study; OCT angiography within the first year of diagnosis (baseline) and at 5-year intervals up to year 10
- Participants
- 143 / 197 / 105
- Exposure
- T1D and T2D vs control participants
- T1Dn = 143
- T2Dn = 197
- Controln = 105reference
- Outcome
- Perfusion density and vessel density of SCP
- Follow-up
- Baseline
Methodological detailscluster analysis for phenotype-based diabetes subtypes
- Cluster analysis for phenotype-based diabetes subtypes
Main finding
As reported in the abstract
Expected difference (perfusion density SCP)
−0.0071
P = 0.0276
T2D
Expected difference (vessel density SCP)
−0.0034
P = 0.0184
T2D
Observational data: associations, not effects.
Further findings
Perfusion density of SCP and DCP reduced in both T1D and T2D · up to year 10
- Perfusion density SCP reduced
- P = 0.0365
- Perfusion density DCP reduced
- P = 0.0062
Foveal avascular zone (FAZ) enlarged and CC FD increased within the first year
- T1D: FAZ enlarged
- P = 0.0327
- T1D: CC FD increased
- P = 0.0474
- T2D (more markedly): FAZ enlarged
- P = 0.0006
- T2D (more markedly): CC FD increased
- P < 0.0001
Occurrence of microaneurysms in SCP and DCP · year 5 and year 10
- SCP, year 5
- P = 0.0209
- DCP, year 5
- P = 0.0279
- SCP, year 10
- P = 0.0220
- DCP, year 10
- P = 0.0007
Associations of microaneurysms
- Microaneurysms in SCP and DCP associated with decreased perfusion density and vessel density in SCP and ICP
- Microaneurysms associated with decreased ganglion cell layer and inner plexiform layer thickness
Original publication
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