Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Sep 28, 2024; 16(9): 407-417
Published online Sep 28, 2024. doi: 10.4329/wjr.v16.i9.407
Retinal microcirculation changes in prediabetic patients with short-term increased blood glucose using optical coherence tomography angiography
Bing-Jing Lv, Hang-Jia Zuo, Qi-Fu Li, Fan-Fan Huang, Tong Zhang, Rong-Xi Huang, Shi-Jie Zheng, Wen-Juan Wan, Ke Hu
Bing-Jing Lv, Chongqing Medical University, Chongqing 400000, China
Bing-Jing Lv, Department of Ophthalmology, Dianjiang People’s Hospital of Chongqing, Chongqing 4008300, Chongqing, China
Hang-Jia Zuo, Tong Zhang, Wen-Juan Wan, Ke Hu, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing 400016, China
Qi-Fu Li, Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Fan-Fan Huang, Shi-Jie Zheng, Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Rong-Xi Huang, Chongqing People’s Hospital, Chongqing 400000, China
Co-first authors: Bing-Jing Lv and Hang-Jia Zuo.
Co-corresponding authors: Wen-Juan Wan and Ke Hu.
Author contributions: Lv BJ and Zuo HJ participated in the data curation, investigation, methodology, writing, and original draft of this article; Li QF, Huang FF, and Zhang T participated in the formal analysis and data curation; Wan WJ was involved in the formal analysis and validation; Ke H participated in the conceptualization, funding acquisition, writing, review and editing, and supervision; Lv BJ and Zuo HJ contributed equally to this work, and Hu K and Wan WJ contributed equally to this work.
Supported by The Project Foundation of Chongqing Science and Technology Commission of China, No. cstc2018jcyjAX0798.
Institutional review board statement: This study was approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University, with approval No. 2021-648 and an approval date of December 30, 2021.
Informed consent statement: Informed consent was obtained from all subjects involved in the study.
Conflict-of-interest statement: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ke Hu, MD, PhD, Doctor, Professor, Researcher, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical University, No. 1 Yuanjiagang Youyi Road, Yuzhong District, Chongqing 400016, China. cqhuke@hospital.cqmu.edu.cn
Received: January 30, 2024
Revised: August 3, 2024
Accepted: September 9, 2024
Published online: September 28, 2024
Processing time: 240 Days and 17 Hours
Abstract
BACKGROUND

Retinal microcirculation alterations are early indicators of diabetic microvascular complications. Optical coherence tomography angiography (OCTA) is a noninvasive method to assess these changes. This study analyzes changes in retinal microcirculation in prediabetic patients during short-term increases in blood glucose using OCTA.

AIM

To investigate the changes in retinal microcirculation in prediabetic patients experiencing short-term increases in blood glucose levels using OCTA.

METHODS

Fifty volunteers were divided into three groups: Group 1 [impaired fasting glucose (IFG) or impaired glucose tolerance (IGT)], Group 2 (both IFG and IGT), and a control group. Retinal microcirculation parameters, including vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) metrics, were measured using OCTA. Correlations between these parameters and blood glucose levels were analyzed in both the fasting and postprandial states.

RESULTS

One hour after glucose intake, the central VD (P = 0.023), central PD (P = 0.026), and parafoveal PD (P < 0.001) were significantly greater in the control group than in the fasting group. In Group 1, parafoveal PD (P < 0.001) and FAZ circularity (P = 0.023) also increased one hour after glucose intake. However, no significant changes were observed in the retinal microcirculation parameters of Group 2 before or after glucose intake (P > 0.05). Compared with the control group, Group 1 had a larger FAZ area (P = 0.032) and perimeter (P = 0.018), whereas Group 2 had no significant differences in retinal microcirculation parameters compared with the control group (P > 0.05). Compared with Group 1, Group 2 had greater central VD (P = 0.013) and PD (P = 0.008) and a smaller FAZ area (P = 0.012) and perimeter (P = 0.010). One hour after glucose intake, Group 1 had a larger FAZ area (P = 0.044) and perimeter (P = 0.038) than did the control group, whereas Group 2 showed no significant differences in retinal microcirculation parameters compared with the control group (P > 0.05). Group 2 had greater central VD (P = 0.042) and PD (P = 0.022) and a smaller FAZ area (P = 0.015) and perimeter (P = 0.016) than Group 1. At fasting, central PD was significantly positively correlated with blood glucose levels (P = 0.044), whereas no significant correlations were found between blood glucose levels and OCTA parameters one hour after glucose intake.

CONCLUSION

A short-term increase in blood glucose has a more pronounced effect on retinal microcirculation in prediabetic patients with either IFG or IGT.

Keywords: Prediabetes; Blood glucose; Optical coherence tomography angiography; Retinal microcirculation; Central vessel density; Impaired fasting glucose; Impaired glucose tolerance

Core Tip: Explore prediabetes-related retinal microcirculation changes with Optical coherence tomography angiography. Categorizing volunteers into Impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and controls, our study reveals postprandial shifts in vessel density, perfusion density (PD), and foveal avascular zone (FAZ) metrics. Noteworthy findings include increased FAZ circularity in IFG/IGT, larger FAZ area/perimeter in IFG, and positive correlation of fasting PD with blood glucose. This novel analysis provides insights into the nuanced impact of short-term blood glucose elevation on retinal microcirculation in prediabetes. Clinicians and researchers, stay tuned for potential clinical implications!