Evolution of Quantitative Optical Coherence Tomography Angiography Markers with Glycemic Control: A Pilot Study

Thibault Ruiz , Anne Dutour (1) , Danièle Denis , Alban Comet , Martin Eisinger , Marie Houssays (1) , Patrice Darmon , Sandrine Boullu , Astrid Soghomonian , Thierry David , Bénédicte Gaborit (1) , Pierre Gascon

1 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research

Aim: We aimed to analyze changes in retinal microvascularization with intensive reduction of glycated hemoglobin A1c (HbA1c) in patients with poorly controlled diabetes using quantitative optical coherence tomography angiography (OCT-A) metrics. Method: This was a retrospective observational study in patients with uncontrolled diabetes admitted to the hospital for glycemic control. A second set of 15 healthy volunteers was included to serve as a control group. OCT-A was performed at inclusion and at 3 months to measure foveal avascular zone area (FAZA), vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP), acircularity index (AI), and fractal dimension (FD). Results: This analysis included 35 patients (35 eyes): 28 type-2 diabetics and 7 type-1 diabetics. Mean HbA1c was 13.1 ± 2.0% at inclusion and 7.0 ± 1.5% at 3 months. In the short period from inclusion to 3 months post-inclusion, patients showed significant decrease in VD–DCP (28.8% vs. 27.8%; p = 0.014), a significant increase in FAZA (0.300 mm2 vs. 0.310 mm2; p < 0.001), and a significant increase in AI (1.31 vs. 1.34; p < 0.01). Multivariate analysis found an increase in FAZA was correlated with baseline HbA1c level and age (R2 = 0.330), and a decrease in VD-DCP was correlated with HbA1c decrease and diabetes duration (R2 = 0.286). Conclusions: Rapid glycemic control in patients with uncontrolled diabetes led to possible short-term microvascular damage that correlated to both initial and decreased HbA1c.

Mots clés: diabetes; optical coherence tomography angiography; diabetic retinopathy; diabetic maculopathy

Domaines: Sciences du Vivant [q-bio]

Thibault Ruiz, Anne Dutour, Danièle Denis, Alban Comet, Martin Eisinger, et al.. Evolution of Quantitative Optical Coherence Tomography Angiography Markers with Glycemic Control: A Pilot Study. Biomedicines, 2022, 10 (10), pp.2421. ⟨10.3390/biomedicines10102421⟩. ⟨hal-03922443⟩