Результаты изучения ретинального кровотока у беременных с сахарным диабетом с помощью оптической когерентной томографии-ангиографии

Abstract

Purpose. To study retinal blood flow in pregnant women with disorders of carbohydrate metabolism using optical coherence tomography angiography (OCTA). Material and methods. 203 pregnant women in the third trimester of pregnancy were examined: 24 — with type 1 and 2 diabetes (T1D and T2D), 143 — with gestational diabetes (GD), and 36 healthy women with physiological pregnancy, who consisted the control group. OCTA imaging was performed using the RTVue XR Avanti OCT 6 mm × 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. Among studied patients no significant differences in VD and in FAZ area were found. VDF in pregnant women with diabetes was significantly less than in pregnant women with GD and in the control group. There were no significant differences in the studied parameters in groups with different periods of GD manifestation. In pregnant women with diabetes with presence and absence of DR, retinal blood flow did not differ significantly. Given the absence of differences of studied parameters in pregnant women with diabetes without DR and with DR, it can be assumed that the retinal microvascular regulation changes due to chronic disorders of carbohydrate metabolism in patients with diabetes and the development of microangiopathy. In 2 patients with T1D and the absence of ophthalmoscopic signs of DR, OCTA revealed areas of nonperfusion in the posterior pole of the eye. Conclusion. OCTA helps to identify areas of retinal nonperfusion in the posterior pole of the eye in pregnant women with diabetes in the absence of ophthalmoscopic signs of DR. Keywords: optical coherence tomography angiography, pregnancy, diabetic retinopathy, retinal blood flow