AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence to...AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence tomography angiography(OCTA).METHODS:A total of 60 female participants were recruited,comprising 20 patients with T2DM,20 patients with GDM,and 20 healthy age-matched controls(HCs).OCTA was used to assess superficial and deep retinal and conjunctival capillary plexuses.Subsequently,changes in MCD were analyzed using a circular segmentation method(C1-C6),a hemispheric quadrant segmentation method[superior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and the early treatment diabetic retinopathy study(ETDRS)segmentation method(S,I,R,L).RESULTS:OCTA unequivocally demonstrated that the variations in CVD among HCs,T2DM,and GDM groups were statistically significant(P<0.001).In the superficial retinal capillary plexus(sRCP),significant differences were observed in the densities of total microvascular(TMI),microvasculature(MIR),and macrovascular(MAR)between patients with T2DM and HCs(P<0.05).Furthermore,the GDM group exhibited a more substantial reduction in MIR density compared to the T2DM group(P<0.01).In the deep retinal capillary plexus(dRCP),significant differences in the densities of TMI and MIR were identified between the T2DM group and HCs(P<0.05),with a notable difference in TMI density also observed between the GDM and T2DM groups(P<0.01).In the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve(AUC)for TMI in sRCP between the T2DM group and HCs was 0.975,with a 95%confidence interval(CI)of 0.941–1.The AUC for MIR was highest in dRCP,with an AUC value of 0.914 and a 95%CI ranging from 0.847 to 0.981.In comparing the GDM and T2DM groups,the AUC for I region was maximized in sRCP,achieving a value of 0.978 with a 95%CI of 0.953–1.Additionally,the AUC for R region was maximized in dRCP,reaching a value of 0.99 with a 95%CI of 0.975 to 1.CONCLUSION:The sRCP and dRCP densities show higher diagnostic sensitivity for T2DM and GDM.OCTA holds potential as a significant instrument for the early diagnosis and differentiation of T2DM and GDM.展开更多
基金Supported by National Natural Science Foundation of China(No.82160195,No.82460203)The Science and Technology Innovation Program of Changde City(No.2023YD25).
文摘AIM:To evaluate alterations in conjunctival vascular density(CVD)and macular capillary density(MCD)in female patients with type 2 diabetes mellitus(T2DM)and gestational diabetes mellitus(GDM)using optical coherence tomography angiography(OCTA).METHODS:A total of 60 female participants were recruited,comprising 20 patients with T2DM,20 patients with GDM,and 20 healthy age-matched controls(HCs).OCTA was used to assess superficial and deep retinal and conjunctival capillary plexuses.Subsequently,changes in MCD were analyzed using a circular segmentation method(C1-C6),a hemispheric quadrant segmentation method[superior right(SR),superior left(SL),inferior left(IL),and inferior right(IR)],and the early treatment diabetic retinopathy study(ETDRS)segmentation method(S,I,R,L).RESULTS:OCTA unequivocally demonstrated that the variations in CVD among HCs,T2DM,and GDM groups were statistically significant(P<0.001).In the superficial retinal capillary plexus(sRCP),significant differences were observed in the densities of total microvascular(TMI),microvasculature(MIR),and macrovascular(MAR)between patients with T2DM and HCs(P<0.05).Furthermore,the GDM group exhibited a more substantial reduction in MIR density compared to the T2DM group(P<0.01).In the deep retinal capillary plexus(dRCP),significant differences in the densities of TMI and MIR were identified between the T2DM group and HCs(P<0.05),with a notable difference in TMI density also observed between the GDM and T2DM groups(P<0.01).In the receiver operating characteristic(ROC)curve analysis,the area under the ROC curve(AUC)for TMI in sRCP between the T2DM group and HCs was 0.975,with a 95%confidence interval(CI)of 0.941–1.The AUC for MIR was highest in dRCP,with an AUC value of 0.914 and a 95%CI ranging from 0.847 to 0.981.In comparing the GDM and T2DM groups,the AUC for I region was maximized in sRCP,achieving a value of 0.978 with a 95%CI of 0.953–1.Additionally,the AUC for R region was maximized in dRCP,reaching a value of 0.99 with a 95%CI of 0.975 to 1.CONCLUSION:The sRCP and dRCP densities show higher diagnostic sensitivity for T2DM and GDM.OCTA holds potential as a significant instrument for the early diagnosis and differentiation of T2DM and GDM.
