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Correlations between macular microvascular parameters in patients with type 2 diabetes mellitus and urinary albumin creatinine ratio

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Author:
No author available
Journal Title:
Chinese Journal of Ocular Fundus Diseases
Issue:
4
DOI:
10.3760/cma.j.cn511434-20210518-00256
Key Word:
糖尿病,2型;局部血流;体层摄影术,光学相干;糖尿病肾病;糖尿病血管病变;Diabetes mellitus, type 2;Regional blood flow;Tomography, optical coherence;Diabetic nephropathies;Diabetic angiopathies

Abstract: Objective:To observe and analyze the correlation between macular microvascular parameters and urinary albumin to creatinine ratio (UACR) in patients with type 2 diabetes mellitus (T2DM).Methods:A cross-sectional study. From October 2017 to April 2018, 100 eyes of 100 patients (T2DM) and 27 eyes of 27 healthy controls (the control group) were enrolled in Xuzhou First People’s Hospital. All subjects underwent anterior segment examination via slit-lamp biomicroscopy, dilated fundus examination, 7-field fundus photographs, OCT angiography (OCTA), the fasting glucose test, glycosylated hemoglobin (HbA1c), urinary albumin, urinary creatinine and UACR levels determination. Height and weight measurement were taken for calculating body mass index (BMI). Diabetic retinopathy was ruled out by fundoscopic examinations and 7-field fundus photographs in T2DM patients. According to the UACR, patients in the T2DM group were subdivided into A1 group (UACR< 30 mg/g), A2 group (UACR 30-300 mg/g), and A3 group (UACR>300 mg/g), with 38 cases and 38 eyes respectively , 40 cases with 40 eyes, 22 cases with 22 eyes. A 6 mm×6 mm scanning area centered on the macular fovea were scanned for right eye using a frequency domain OCTA instrument, which were divided into three concentric circles centered on the macular fovea by the software automatically. The foveal zone was defined as a circular area measuring 1 mm in diameter, the parafoveal zone was described as a middle circle area measuring 1-3 mm in diameter, and the perifoveal zone was an outer circle area measuring 3-6 mm in diameter. The vessel density of superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular area (FAZ) and perimeter (PERIM), non-circularity index (AI) were measured. The correlation between the macular vessel density, FAZ and UACR was analyzed by Spearman correlation analysis.Results:A1 group, A2 group, A3 group, and normal control group. The macular area SCP and DCP ( F=13.722, 5.644), foveal area ( F=4.607, 4.719), parafoveal area ( H=23.142, F=2.904), the blood flow density of the area around the fovea ( F=12.292, H=10.946), the difference was statistically significant ( P<0.05); with the increase of UACR, the blood flow density of each area of SCP and DCP showed a downward trend. The results of correlation analysis showed that the blood flow density of the whole SCP, parafoveal area, and surrounding area of T2DM patients was negatively correlated with UACR ( r=-0.376, -0.240, -0.364,-0.347, P<0.05). There were no correlation among fasting plasma glucose, HbAlc and UACR ( r=0.179, 0.085, P>0.05). There were no correlation among blood flow density in BMI, SCP foveal area, DCP and UACR (| r|<0.3, P>0.05). Conclusion:The whole, parafovea and perifovea vessel density values of SCP in T2DM eyes without DR are negatively correlated with UACR.

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