Quantitative Optical Coherence Tomography Angiography (OCTA) Parameters in a Black Diabetic Population and Correlations with Systemic Diseases.

Lincoln T Shaw,Saira Khanna,Seenu M Hariprasad,Dimitra Skondra,Lindsay Y Chun,Nathalie Massamba,Sarah H Rodriguez,Rose C Dimitroyannis

doi:10.3390/cells10030551

Abstract

This is a cross-sectional, prospective study of a population of black diabetic participants without diabetic retinopathy aimed to investigate optical coherence tomography angiography (OCTA) characteristics and correlations with systemic diseases in this population. These parameters could serve as novel biomarkers for microvascular complications; especially in black populations which are more vulnerable to diabetic microvascular complications. Linear mixed models were used to obtain OCTA mean values ± standard deviation and analyze statistical correlations to systemic diseases. Variables showing significance on univariate mixed model analysis were further analyzed with multivariate mixed models. 92 eyes of 52 black adult subjects were included. After multivariate analysis; signal strength intensity (SSI) and heart disease had statistical correlations to superficial capillary plexus vessel density in our population. SSI and smoking status had statistical correlations to deep capillary plexus vessel density in a univariate analysis that persisted in part of the imaging subset in a multivariate analysis. Hyperlipidemia; hypertension; smoking status and pack-years; diabetes duration; creatinine; glomerular filtration rate; total cholesterol; hemoglobin A1C; and albumin-to-creatinine ratio were not significantly associated with any OCTA measurement in multivariate analysis. Our findings suggest that OCTA measures may serve as valuable biomarkers to track systemic vascular functioning in diabetes mellitus in black patients.

Highlights

Diabetes mellitus (DM) is the most common metabolic disorder worldwide and affects an estimated 463 million people worldwide and 34.2 million people in the United States (U.S.)—about 10.5% of the U.S population [1,2]
These changes are reflected throughout the rest of the body as well, which explains the strong association between diabetic retinopathy (DR) and other microvascular complications of diabetes such as nephropathy and neuropathy [8]
92 eyes of 52 black adult subjects with DM were included in this study. 12 eyes were excluded from the study for meeting exclusion criteria for only one eye

Summary

Introduction

Diabetes mellitus (DM) is the most common metabolic disorder worldwide and affects an estimated 463 million people worldwide and 34.2 million people in the United States (U.S.)—about 10.5% of the U.S population [1,2]. Changes in retinal microvascular structure associated with DR include pericyte and endothelial cell loss, decreased perfusion, and ischemia which leads to upregulation of pro-angiogenic factors (such as vascular endothelial growth factor [VEGF]) and subsequent neovascularization [7]. These changes are reflected throughout the rest of the body as well, which explains the strong association between DR and other microvascular complications of diabetes such as nephropathy and neuropathy [8]. Recent studies have correlated microvascular complications in diabetics (including DR) with generalized vascular dysfunction and an increased risk of cardiovascular disease and all-cause mortality [9], independent of other risk factors such as diabetes duration, glycemic control, smoking, and lipid profile [10]

Results

Discussion

Conclusion