Оптическая когерентная томография-ангиография в исследовании ретинального кровотока у беременных с сахарным диабетом

Abstract

Purpose. To study retinal blood flow in pregnant women with diabetes using optical coherence tomography angiography (OCTA). Material and methods. 60 pregnant women were examined: 24 women had type 1 and 2 diabetes (T1D and T2D) and 36 healthy women with physiological pregnancy consisted the control group. Pregnant women with diabetes were examined in three trimesters of pregnancy, the control group – in the third trimester. OCTA imaging was performed using the RTVue XR Avanti OCT 6×6 mm Angio Retina scan protocols (Optovue, USA). The vascular density (VD), vascular density in the fovea (VDF), and foveal avascular zone (FAZ) area in the superficial capillary plexus were studied. Results. In the third trimester, VDF in pregnant women with diabetes was significantly less than in the control group, in the absence of differences in VD and FAZ area. VD was significantly lower, and FAZ area was significantly higher in pregnant women with diabetic retinopathy (DR) than in pregnant women with diabetes without DR. There were no significant differences in the values of blood flow parameters in the groups of pregnant women with diabetes, regardless of underwent them the laser coagulation of the retina. At analyzing the values of VD, VDF, FAZ area in pregnant women with diabetes in different trimesters of pregnancy, statistically significant differences were not observed. In 11 pregnant women with DR areas of retinal nonperfusion were revealed, which in 6 patients tended to expand during pregnancy. In 2 patients with T1D without DR in the third trimester areas of nonperfusion were identified. Conclusion. Obtained data have practical importance for the diagnosis of DR manifestations during pregnancy. OCTA is a valuable diagnostic method that allows non-invasive diagnostics of the presence of areas of retinal nonperfusion in the absence of ophthalmoscopic signs of DR in pregnant women with diabetes, as well as assess the state of areas of retinal nonperfusion during pregnancy in patients with DR. Key words: optical coherence tomography angiography, diabetic retinopathy, pregnancy.