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Exp Clin Endocrinol Diabetes 2024; 132(09): 522-530
DOI: 10.1055/a-2316-3903
Article

Optical Coherence Tomography Angiography Evaluation of Retinochoroidal Microvascular Circulation Differences in Pregnant Women with Pregestational and Gestational Diabetes Mellitus

Çisil Erkan Pota 
1   The Department of Ophthalmology, Manavgat State Hospital, Antalya, Turkey
,
Mehmet E Doğan
2   The Department of Ophthalmology, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Gül Alkan Bülbül 
3   The Department of Obstetrics and Gynecology, Division of Perinatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Cem Y Sanhal 
3   The Department of Obstetrics and Gynecology, Division of Perinatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
,
Ali Pota
4   The Department of Obstetrics and Gynecology, Antalya Ministry of Health Kepez State Hospital, Antalya, Turkey
› Author Affiliations
Funding The authors received no funding for the research, authorship, and/or publication of this article from any government or private institution.
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Abstract

Purpose In this study, the changes in microvascular circulation caused by pregestational and gestational diabetes were observed, without focusing on retinal findings, to reveal the effect of diabetes regulation.

Methods A total of 135 subjects were included: 30 with gestational diabetes (GDM), 30 pregestational diabetes (PGDM), 30 healthy pregnant normoglycemic subjects, and 45 healthy non-pregnant subjects. All subjects were examined by optical coherence tomography (OCT) and angiography. The retina, retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), choroidal thickness (CT), superficial capillary plexus (SCP), deep capillary plexus (DCP), choriocapillaris (CC), vascular density (VD), and foveal avascular zone (FAZ) areas were measured.

Results The foveal VD of SCP and DCP was significantly lower in the PGDM and GDM groups compared to the control groups (p:0.006 and p:0.001, respectively). CC VD was significantly higher in all pregnant groups compared to non-pregnant controls (p<0.001). The choroidal thickness values were highest in the healthy pregnant group and lowest in the PGDM group. There was no significant difference in FAZ area, retina, RNFL and GCL thickness between the groups. In the PGDM group, a negative correlation was observed between the FAZ area and the HbA1c level (r:− 0.417, p:0.043).

Conclusion There was a decrease in vascular density in pregnant women with diabetes compared to healthy pregnant women and controls. In the pregnant group with PGDM, a narrowing of the FAZ area was observed with increasing worsening of diabetes control. Diabetes type and glycemic control could influence the microvascular changes even in the absence of clinical or retinal findings.

Keywords

foveal avascular zone area - gestational diabetes mellitus - optical coherence tomography angiography - pregestational diabetes mellitus - retinal capillary - vascular density


Publication History

Received: 10 January 2024
Received: 19 April 2024

Accepted: 22 April 2024

Article published online:
06 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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