Optical coherence tomography angiography for detection of microvascular changes in early diabetes: A systematic review and meta-analysis

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes/Metabolism Research and Reviews Pub Date : 2024-05-13 DOI:10.1002/dmrr.3812

Fan Yang, Weijie Zou, Zhiwei Li, Yuanyuan Du, Weiyun Gao, Ji Zhang, Xiaoyan Ji, Jiang Huang

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Abstract

Aims

To evaluate the effectiveness of optical coherence tomography angiography (OCTA) in detecting early intraocular microvascular changes in diabetic patients.

Materials and Methods

A systematic study search was performed on PubMed, Medline, Embase, and the Cochrane Library, ranging from January 2012 to March 2023. Controlled studies compared diabetes mellitus (DM) patients with non-diabetic retinopathy (NDR) or patients with mild non-proliferative diabetic retinopathy (mild NPDR) to healthy people. These studies included parameters of OCTA such as foveal avascular zone (FAZ), vessel density of superficial capillary plexus (VDscp), vessel density of deep capillary plexus (VDdcp), and peripapillary VD. The relevant effect model was used according to the heterogeneity, and the mean difference and 95% confidence intervals were calculated.

Results

A total of 18 studies with 2101 eyes were eventually included in this meta-analysis. Our results demonstrated that early alterations of VDscp, VDdcp, and peripapillary VD in NDR patients had a significant difference compared with healthy people by OCTA (VDscp: WMD = −1.34, 95% CI: −1.99 to −0.68, P < 0.0001. VDdcp: WMD = −2.00, 95% CI: −2.95 to −1.04, P < 0.0001. Peripapillary VD: WMD = −1.07, 95% CI: −1.70 to −0.43, P = 0.0010). However, there was no statistically significant difference in total FAZ between them (WMD = −0.00, 95% CI: −0.02–0.01, P = 0.84). In addition, for patients with mild NPDR, OCTA could illustrate prominent changes in VDscp, VDdcp, and total FAZ compared with healthy people (VDscp: WMD = −6.11, 95% CI: −9.90 to −2.32, P = 0.002. VDdcp: WMD = −4.26, 95% CI: −5.95 to −2.57, P < 0.00001. FAZ: WMD = 0.06, 95% CI: 0.01–0.11, P = 0.03).

Conclusions

In diabetic patients with or without retinopathy, the parameters of OCTA such as VDscp, VDdcp, and peripapillary vessel density were demonstrated as potential biomarkers in monitoring the early alterations of retinal microangiopathy, while total FAZ may have no significant changes in diabetic patients without retinopathy.

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用于检测早期糖尿病微血管变化的光学相干断层血管造影术：系统回顾和荟萃分析。

目的：评估光学相干断层血管成像（OCTA）在检测糖尿病患者早期眼内微血管病变方面的有效性：在 PubMed、Medline、Embase 和 Cochrane 图书馆进行了系统性研究检索，检索时间为 2012 年 1 月至 2023 年 3 月。对照研究将患有非糖尿病视网膜病变（NDR）的糖尿病（DM）患者或患有轻度非增殖性糖尿病视网膜病变（轻度 NPDR）的患者与健康人进行了比较。这些研究包括 OCTA 参数，如眼窝无血管区（FAZ）、浅层毛细血管丛血管密度（VDscp）、深层毛细血管丛血管密度（VDdcp）和毛细血管周围血管密度。根据异质性采用相关效应模型，并计算平均差异和 95% 的置信区间：荟萃分析共纳入了 18 项研究，2101 只眼睛。结果表明，通过 OCTA 观察，NDR 患者 VDscp、VDdcp 和毛细血管周围 VD 的早期改变与健康人相比有显著差异（VDscp：WMD=-1.34，95% CI：-1.99 至 -0.68，P 结论：在有视网膜病变或无视网膜病变的糖尿病患者中，OCTA 的参数如 VDscp、VDdcp 和毛细血管密度被证明是监测视网膜微血管病变早期改变的潜在生物标志物，而总 FAZ 在无视网膜病变的糖尿病患者中可能没有明显变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes/Metabolism Research and Reviews 医学-内分泌学与代谢

CiteScore

17.20

自引率

2.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Diabetes/Metabolism Research and Reviews is a premier endocrinology and metabolism journal esteemed by clinicians and researchers alike. Encompassing a wide spectrum of topics including diabetes, endocrinology, metabolism, and obesity, the journal eagerly accepts submissions ranging from clinical studies to basic and translational research, as well as reviews exploring historical progress, controversial issues, and prominent opinions in the field. Join us in advancing knowledge and understanding in the realm of diabetes and metabolism.