scholarly journals Swept-source OCTA quantification of capillary closure predicts ETDRS severity staging of NPDR

2020 ◽  
pp. bjophthalmol-2020-317890
Author(s):  
Torcato Santos ◽  
Lewis H Warren ◽  
Ana Rita Santos ◽  
Inês Pereira Marques ◽  
Sophie Kubach ◽  
...  
Keyword(s):  
Gold Standard ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Circulation ◽  
Swept Source ◽  
Retinal Capillary ◽  
Patients With Diabetes ◽  
Capillary Circulation ◽  
Swept Source Octa

PurposeTo test whether a single or composite set of parameters evaluated with optical coherence tomography angiography (OCTA), representing retinal capillary closure, can predict non-proliferative diabetic retinopathy (NPDR) staging according to the gold standard ETDRS grading scheme.Methods105 patients with diabetes, either without retinopathy or with different degrees of retinopathy (NPDR up to ETDRS grade 53), were prospectively evaluated using swept-source OCTA (SS-OCTA, PlexElite, Carl Zeiss Meditec) with 15×9 mm and 3×3 mm angiography protocols. Seven-field photographs of the fundus were obtained for ETDRS staging. Eyes from age-matched healthy subjects were also imaged as control.ResultsIn eyes of patients with type 2 diabetes without retinopathy or ETDRS levels 20 and 35, retinal capillary closure was in the macular area, with predominant alterations in the parafoveal retinal circulation (inner ring). Retinal capillary closure in ETDRS stages 43–53 becomes predominant in the retinal midperiphery with vessel density average values of 25.2±7.9 (p=0.001) in ETDRS 43 and 23.5±3.4 (p=0.001) in ETDRS 47–53, when evaluating extended areas of 15×9 protocol. Combination of acquisition protocols 3×3 mm and 15×9 mm, using SS-OCTA, allows discrimination between eyes with mild NPDR (ETDRS 10, 20, 35) and eyes with moderate-to-severe NPDR (ETDRS grades 43–53).ConclusionsRetinal capillary closure, quantified by SS-OCTA, can identify NPDR severity progression. It is located mainly in the perifoveal retinal capillary circulation in the initial stages of NPDR, whereas the retinal midperiphery is predominantly affected in moderate-to-severe NPDR.

scholarly journals Retinal Capillary Nonperfusion on OCT-Angiography and Its Relationship to Kidney Function in Patients with Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Elysse S. Tom ◽  
Steven S. Saraf ◽  
FuPeng Wang ◽  
Qinqin Zhang ◽  
Gautam Vangipuram ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Kidney Function ◽  
Optical Coherence Tomography Angiography ◽  
Creatinine Ratio ◽  
Swept Source ◽  
Urine Albumin ◽  
Retinal Capillary ◽  
Patients With Diabetes

Background. Diabetic retinopathy and kidney disease share underlying mechanisms of microvascular damage and are often comorbid in people with diabetes. We evaluated whether there is a relationship between retinal capillary perfusion as measured by swept-source optical coherence tomography angiography and estimated glomerular filtration rate (eGFR) and albuminuria in patients with diabetes and chronic kidney disease (CKD). Method. A cross-sectional pilot study was conducted at the University of Washington among a subset of participants with diabetes and CKD participating in a larger cohort study. Participants were excluded if they were known to have kidney disease from conditions other than diabetes. Ten participants (11 eyes) were included. Retinal nonperfusion (RNP) and vessel density (VD) were measured by swept-source optical coherence tomography angiography in 30° and 60° field of view (FOV) regions centered at the fovea. Correlations of RNP and VD with eGFR and albuminuria were analyzed. Results. Participants had a mean age of 72 years, hemoglobin A1c of 8.1%, eGFR of 45 mL/min/1.73 m2, and urine albumin-to-creatinine ratio of 162 mg/g. Mean (SD) RNP was 6.6% (4.2%) and 16.9% (7.7%) in 30° and 60° FOV regions, respectively. eGFR was negatively correlated to RNP in both the 30° and 60° FOV regions (R = −0.69, p = 0.004 , and R = −0.46, p = 0.057 , respectively), and correlations were stronger among a subset of 7 participants with evidence of diabetic retinopathy on exam and fundus photos. The estimated GFR was not significantly correlated with vessel density. Urine albumin-to-creatinine ratio was not significantly correlated with RNP or VD. Conclusions. Our proof-of-concept study showed that lower eGFR was significantly correlated with retinal nonperfusion in participants with diabetes and CKD. Advanced retinal imaging may enhance the noninvasive evaluation of kidney function in diabetes.

scholarly journals Oral Symptoms and Mucosal Lesions in Patients with Diabetes Mellitus Type 2

2017 ◽  
Vol 21 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Ana Cicmil ◽  
Olivera Govedarica ◽  
Jelena Lečić ◽  
Snežana Mališ ◽  
Smiljka Cicmil ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Oral Cavity ◽  
Healthy Subjects ◽  
Control Level ◽  
Type 2 Diabetics ◽  
Significant Difference ◽  
Oral Mucosal Lesions ◽  
Patients With Diabetes ◽  
Mucosal Lesions

Summary Background: Good glycoregulation at patients with diabetes mellitus is essential for prevention of many complications, including those in oral cavity. Results of numerous studies indicate that xerostomia and neurosensory oral disorders are present in type 2 diabetics. A review of the literature shows contradictory results about prevalence of oral mucosal lesions in diabetics. The aim of this study was to evaluate the presence of xerostomia, neurosensory disorders and mucosal lesions in oral cavity of type 2 diabetics. Material and Methods: This study involved 90 adults, 60 with type 2 diabetes and 30 healthy subjects, aged 45-65 years. With regard to value of HbA1c level diabetics were divided into two groups: 30 subjects with satisfactory glycoregulation (HbA1c<9%) and 30 subjects with poor glycoregulation (HbA1c≥9%). All patients recruited into the study completed a questionnaire that included their demographic, medical and oral health data. Clinical examination of the oral mucosa was performed by a single examiner. Results: In relation to the presence of xerostomia and dysgeusia between satisfactory controlled diabetics and healthy subjects a significant difference was observed (p<0.05). Compared with healthy subjects, poor controlled diabetics had significantly higher presence of xerostomia (p<0.001) and neurosensory disoders (p<0.05). A higher prevalence of oral mucosal lesions was found in poor controlled diabetics, but significant difference between groups was not observed (p>0.05). A significant positive correlation was revealed between smoking and glossodynia as well as smoking and glossopyrosis (p>0.05). Conclusion: Glycemic control level seems to influence the susceptibility of type 2 diabetics to xerostomia and neurosensory disorders. Less clear is whether diabetes are corellated to oral mucosal lesions.

scholarly journals Quantitative assessment of choriocapillaris flow deficits in diabetic retinopathy: A swept-source optical coherence tomography angiography study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243830
Author(s):  
Yining Dai ◽  
Hao Zhou ◽  
Qinqin Zhang ◽  
Zhongdi Chu ◽  
Lisa C. Olmos de Koo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Optical Coherence ◽  
Swept Source ◽  
Significant Difference ◽  
En Face ◽  
The Mean

Purpose To quantitatively assess choriocapillaris (CC) flow deficits in eyes with diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA). Methods Diabetic subjects with different stages of DR and age-matched healthy subjects were recruited and imaged with SS-OCTA. The en face CC blood flow images were generated using previously published and validated algorithms. The percentage of CC flow deficits (FD%) and the mean CC flow deficit size were calculated in a 5-mm-diameter circle centered on the fovea from the 6×6-mm scans. Results Forty-five diabetic subjects and 27 control subjects were included in the study. The CC FD% in diabetic eyes was on average 1.4-fold greater than in control eyes (12.34±4.14% vs 8.82±2.61%, P < 0.001). The mean CC FD size in diabetic eyes was on average 1.4-fold larger than in control eyes (2151.3± 650.8μm2 vs 1574.4±255.0 μm2, P < 0.001). No significant difference in CC FD% or mean CC FD size was observed between eyes with nonproliferative DR and eyes with proliferative DR (P = 1.000 and P = 1.000, respectively). Conclusions CC perfusion in DR can be objectively and quantitatively assessed with FD% and FD size. In the macular region, both CC FD% and CC FD size are increased in eyes with DR. SS-OCTA provides new insights for the investigations of CC perfusion status in diabetes in vivo.

Anterior segment optical coherence tomography angiography for iris vasculature in pigmented eyes

2020 ◽  
pp. bjophthalmol-2020-316930
Author(s):  
Marcus Ang ◽  
Kavya Devarajan ◽  
Anna CS Tan ◽  
Mengyuan Ke ◽  
Bingyao Tan ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Anterior Segment ◽  
Mean Difference ◽  
Vessel Density ◽  
Optical Coherence ◽  
Swept Source ◽  
Density Measurements ◽  
Stage 1 ◽  
Swept Source Octa

PurposeTo compare anterior segment optical coherence tomography angiography (AS-OCTA) systems in delineating normal iris vessels and iris neovascularisation (NVI) in eyes with pigmented irides.MethodsProspective study from January 2019 to June 2019 of 10 consecutive patients with normal pigmented iris, had AS-OCTA scans with a described illumination technique, before using the same protocol in five eyes with NVI (clinical stages 1–3). All scans were sequentially performed using a spectral-domain OCTA (SD-OCTA), and a swept-source OCTA (SS-OCTA, Plex Elite 9000). Images were graded by two masked observers for visibility, artefacts and NVI characteristics. The main outcome measure was iris vessel density measurements comparing SS-OCTA and SD-OCTA systems.ResultsThe median age of subjects was 28 (20–35) years, and 50% were female. The paired mean difference of iris vessel density measurements was 11.7 (95% CI 14.7 to 8.1; p=0.002), SS-OCTA detecting more vessels than SD-OCTA. The inter-rater reliability for artefact score (κ=0.799, p<0.001) and visibility score (κ=0.722; p<0.001) were substantial. Both AS-OCTA systems were able to detect NVI vessels with a fair agreement (κ=0.588), with clearer NVI characteristics in stage 1/2 compared to stage 3 NVI (mean difference NVI score: 2.7±0.4, p=0.009).ConclusionThe SS-OCTA was better able to delineate iris vessels in normal pigmented irides compared to SD-OCTA. Both AS-OCTA systems identified NVI characteristics based on its atypical configuration or location, but further improvements are needed to allow for more accurate objective, serial quantification for clinical use.

scholarly journals Quantitative changes in the ageing choriocapillaris as measured by swept source optical coherence tomography angiography

2018 ◽  
Vol 103 (9) ◽  
pp. 1320-1326 ◽  
Author(s):  
Riccardo Sacconi ◽  
Enrico Borrelli ◽  
Eleonora Corbelli ◽  
Luigi Capone ◽  
Alessandro Rabiolo ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Negative Correlation ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Central Area ◽  
Optical Coherence ◽  
Strong Negative Correlation ◽  
Swept Source ◽  
Foveal Region ◽  
Age Related

AimTo analyse quantitative optical coherence tomography angiography (OCTA) parameters of choriocapillaris (CC) at the foveal, perifoveal and parafoveal regions in healthy subjects of different age.MethodsIn this observational cross-sectional study, consecutive healthy subjects underwent swept source OCTA (PLEX Elite 9000, Carl Zeiss Meditec, USA). 3×3 mm and 6×6 mm scans centred on the fovea were acquired analysed and postprocessed with thresholding and binarisation processes. The main outcome measures included CC quantitative OCTA features (perfusion density (PD), vessel length density (VLD) and vessel diameter index (VDI)) at the foveal, perifoveal and parafoveal regions, and their relationship with age.ResultsSeventy-two eyes (72 patients, mean age 47.4±19.2 years, mean axial length 24.0±0.7 mm) were included. The mean PD was statistically lower in the foveal region compared with the parafoveal region in 3×3 mm scans (p=0.009). In subjects aged 70–80, PD of the foveal region was significantly reduced compared with the perifoveal region in 6×6 mm scans (p=0.008). A strong negative correlation was found between PD and ageing in the foveal, parafoveal and perifoveal regions (p<0.001 in all analyses). Furthermore, PD in the nasal-perifoveal region was significantly lower than the temporal-perifoveal region (p=0.005). No significant correlation was found between VLD and age in all regions, whereas VDI was strictly correlated with age (p<0.001).ConclusionsWe reported in vivo a strong negative correlation between PD and ageing in the CC of healthy subjects. This reduction seems related to a reduced diameter, and not to a reduced number, of capillaries. The age-related changes were higher in the central area compared with the perifoveal area.

scholarly journals Examining and Comparing Executive Functions in Patients with Type 2 Diabetes Subjects and Healthy Subjects

2017 ◽  
Vol 8 (3) ◽  
pp. 293-296
Author(s):  
Ahmad Alipour ◽  
Fariborz Bagheri ◽  
Mahnaz AliAkbari-Dehkordi ◽  
Fatemeh Amirabadi
Keyword(s):  
Type 2 Diabetes ◽  
Disease Management ◽  
Executive Functions ◽  
Healthy Subjects ◽  
Comparative Method ◽  
Control Group ◽  
Patients With Diabetes ◽  
Research Population ◽  
Range Of Functions

Abstract Today, diabetes is a serious problem worldwide, as WHO predicts, in the year 2025, the population suffering from diabetes will be about 333 million adults (Norouzi, Ghafranipour, Heidarnia, Tahmasbi, 2010). Disease Management requires planning and problem solving capabilities which as a range of functions are categorized as executive functions. Executive functions are important structures playing a fundamental role in directing and normalizing behavior. Therefore, the study was designed with the goal of comparing and examining patients suffering from type 2 diabetes in contrast with healthy subjects. The study was conducted using a causative-comparative method in 2013-14 in Tehran. Research population were people referring to Gabric association of whom 36 volunteer patients with diabetes were chosen. The control group were chosen amongst patients’ companions with no disease records and were tested by WCST. Findings showed deficiencies in executive functions of patients with type 2 diabetes. Generally, we can say that these deficiencies can prevent proper disease management of type 2 diabetes.

Galacto-oligosaccharides ameliorate dysbiotic Bifidobacteriaceae decline in Japanese patients with type 2 diabetes

2017 ◽  
Vol 8 (5) ◽  
pp. 705-716 ◽  
Author(s):  
M. Gonai ◽  
A. Shigehisa ◽  
I. Kigawa ◽  
K. Kurasaki ◽  
O. Chonan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Gut Microbiota ◽  
Impaired Glucose Tolerance ◽  
Healthy Subjects ◽  
Metabolic Diseases ◽  
Healthy Individuals ◽  
Patients With Diabetes ◽  
Metabolic Endotoxemia

Gut microbiota affects the host’s metabolism, and it is suggested that there are differences in gut microbiota composition between patients with type 2 diabetes and healthy individuals. Additionally, dysbiosis may increase the concentration of lipopolysaccharides (LPS), causing metabolic endotoxemia, which induces impaired glucose tolerance. Several studies have reported relationships between metabolic diseases and the gut microbiota; and prebiotics, such as oligosaccharides, are commonly consumed to regulate gut microbiotas in healthy individuals. Galacto-oligosaccharides (GOS) are a major prebiotic, which specifically increase Bifidobacteriaceae abundance. Recent studies have reported that Bifidobacteriaceae improved metabolic endotoxemia or impaired glucose tolerance. However, there are few studies reporting the effects of GOS on patients with type 2 diabetes. In the current study, we compared clinical parameters, faecal gut microbiota, their associated metabolic products and their components such as LPS, and LPS-binding protein (LBP) produced by the host, between patients with diabetes and healthy controls. We then assessed the effects of GOS on glycaemic control, and gut microbiotas and metabolites in patients with type 2 diabetes in a double-blind controlled manner. LBP levels were significantly higher in patients with diabetes than those of healthy subjects, which was consistent with previous reports. The abundance of Bifidobacteriaceae and the diversity of intestinal microbiota were significantly lower in patients with diabetes than in healthy subjects. Interestingly, Bifidobacteriaceae was markedly restored in patients with diabetes after consumption of GOS, whereas LBP and glucose tolerance did not improve during this short-term trial period. In the present study, we demonstrated that GOS can ameliorate dysbiosis in patients with diabetes, and continuous intake of GOS may be a promising method for managing type 2 diabetes.

scholarly journals The membrane attack complex as an indicator of complement hyperactivation in type 2 diabetes mellitus

2011 ◽  
Vol 14 (3) ◽  
pp. 17-20
Author(s):  
Elina Alexandrovna Arakelova ◽  
Meri Robertovna Ovsepyan ◽  
Anna Surenovna Boyadzhyan ◽  
Arsen Artashesovich Arakelyan ◽  
Astkhik Artavazdovna Gevorkyan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Healthy Subjects ◽  
Membrane Attack Complex ◽  
Complement Components ◽  
Mean Values ◽  
Patients With Diabetes ◽  
History Of ◽  
The Complement System ◽  
Diabetes Mellitus 2

Aim. Comparative analysis of the levels of the membrane attack complex (MAC) - an end product of complement activation, and of hemolytic activitiesof C1 and C3 complement components in sera of patients with diabetes mellitus 2 (DM2) and healthy subjects. Materials and methods. 37 DM2 patients (7 men, 26 women, mean age 58?9 years (M?б) and 37 healthy subjects without a family history of hereditarydiabetes (17 men, 20 women, mean age 52?12 years). Serum MAC levels were measured by ELISA, C1 and C3 hemolytic activities by usingrabbit antibody-sensitized ram erythrocytes and C1, C3-deficient sera. Results. Mean values of all measured parameters in DM2 patients were significantly higher than in controls. Conclusion. Pathogenesis of DM2 is characterized by hyperactivation of the complement system including both the classical and terminal cascadesand by hyperproduction of its cytotoxic products.

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