Müjdat KARABULUT, Aylin KARALEZLİ, Sinem KARABULUT, Sabahattin SÜL

RETİNOPATİ BULGUSU OLMAYAN TİP 2 DİYABETLİ HASTALARDA RETİNAL MİKROVASKÜLER FARKLILIKLAR: OPTİK KOHERANS TOMOGRAFİ ANJİOGRAFİ ÇALIŞMASI

Amaç Bu çalışmada, klinik olarak tespit edilebilen diyabetik retinopati bulgusu olmayan tip 2 diyabetli hastalarda optik koherans tomografi anjiyografi ile mikrovasküler değişimlerin saptanması amaçlanmıştır. Gereç ve Yöntem Çalışma gözlemsel, olgu-kontrol çalışma olarak planlanmıştır. Klinik olarak tespit edilebilen retinopatisi olmayan (Dilate fundus muayenesinde ve fundus fluoresein anjiyografide) 40 tip 2 diyabet hastasının 80 gözü çalışma grubu olarak belirlenmiştir. Yaş ve cinsiyet açısından benzer 40 sağlıklı hastanın 80 sağlam gözü kontrol grubu olarak seçilmiştir. Bütün hastalara tam oftalmolojik muayene sonrası makula merkezli 6x6 mm büyüklüğünde optik koherens tomografi anjiyografi çekimleri yapılmıştır. Derin ve yüzeyel kapiller ağlarda vasküler yoğunluk, foveal avasküler alan, koryokapiller akım alanı parametreleri kontrol grubu ile karşılaştırılmıştır. Bulgular Yaş ve cinsiyet açısından gruplar arasında fark saptanmamıştır (p=0.971 ve p=1.000; sırasıyla). Ortalama diyabet süresi 10.38±6.31 yıl (1-25 yıl aralığında) olarak bulunmuştur. Koryokapiller akım alanı çalışma grubunda anlamlı olarak düşük bulunmuştur (p<0.001). Derin kapiller ağdaki vasküler yoğunluk, fovea dışındaki tüm kadranlarda çalışma grubunda düşük bulunmuştur (p<0.001).Yüzeyel kapiller ağdaki vasküler yoğunluk, parafoveal kadranda çalışma grubunda anlamlı olarak düşük saptanmıştır (p=0.013). İki grup arasıda foveal avasküler alan açısından fark saptanmamıştır. Sonuç Klinik olarak retinopati bulgusu saptanamayan tip 2 diyabetli hastalarda erken dönem vasküler değişimler optik koherans tomografi anjiyografi ile saptanabilir.

Anahtar Kelimeler:

Derin kapiller ağ, Derin kapiller ağ, Diyabetik retinopati, Optik koherans tomografi anjiyografi, Parafoveal vasküler yoğunluk, Vasküler yoğunluk

RETINAL MICROVASCULAR DIFFERENCES IN TYPE 2 DIABETES WITHOUT CLINICALLY APPARENT RETINOPATHY: AN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY STUDY

Objective We aimed to determine early microvascular changes in type 2 diabetes mellitus patients without clinically apparent retinopathy by optical coherence tomography angiography. Material and Methods 80 eyes of patients with diabetes mellitus and without clinically apparent retinopathy, and 80 eyes of age and sex-matched healthy participants were included in this observational case-control study. Vessel density in superficial and deep retinal vessel plexus, foveal avascular zone area, and choriocapillaris flow area in a macular 6.00 × 6.00 mm scan size were evaluated and compared. Results The groups were similar for age and gender (p=0.971 and p=1.000, respectively). The mean duration of diabetes was 10.38±6.31 years (range, 1-25 years) in the study group. Choriocapillaris flow area was significantly lower in the study group than in the control group (p<0.001). Vessel density in the deep retinal plexus was markedly lower in the study group in all quadrants except the fovea (p<0.001). Parafoveal vessel density in superficial retinal plexus was markedly reduced in the study group (p=0.013). The mean foveal avascular zone area was similar in the two groups. Conclusion Optical coherence tomography angiography can detect early microvascular changes in diabetic patients without clinically apparent retinopathy.

Keywords:

Deep capillary plexus, diabetic retinopathy, optical coherence tomography angiography, parafoveal vessel density, vessel density,

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