OCT Angiographic changes in diabetic patients after cataract surgery

Document Type : Original Article

Authors

1 Ophthalmology department - Faculty of Medicine-Beni-Suef University - Beni-Suef - Egypt

2 Ophthalmology department,Faculty of Medicine,Beni-Suef University,Beni-Suef,Egypt

3 Ophthalmology department-faculty of Medicine- Beni-Suef University- Beni-Suef- Egypt

Abstract

The goal of this prospective non-interventional clinical study was to evaluate the role of OCT-A parameters in determining early changes that occur in DM patients following cataract surgery to be aware about early microvascular changes occurring & when to interfere to prevent complications of DR. The study was carried out on 30 eyes of cataractous diabetic patients without DR & 30 eyes of cataractous non diabetic patients, both underwent phaco. Patients were selected according to inclusion & exclusion criteria then complete ophthalmologic evaluation was done (history, examination and investigations). OCT-A was carried out for study groups before &during follow up after one week, one month &three months after surgery. The study showed that there was a significant increase in foveal & parafoveal thickness after three months in comparison with preoperative values & control group by 12±8.97foveal/ 11.40±3.99 parafoveal(p-value

Keywords


Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27(5):1047–53.
2.   Fong DS, Aiello L, Gardner TW, King GL, Blankenship G, Cavallerano JD, et al. Retinopathy in Diabetes. Diabetes Care. 2004; 27(suppl 1):s84–7.
3.    Klein BE, Klein R, Moss SE. Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Am J Ophthalmol. 1995; 119(3):295–300.
4.   Klein BE, Klein R, Wang Q, Moss SE. Older-onset diabetes and lens opacities. The Beaver Dam Eye Study. Ophthalmic Epidemiol. 1995; 2(1):49–55.
5.   Klein BE, Klein R, Moss SE. Prevalence of cataracts in a population-based study of persons with diabetes mellitus. Ophthalmology. 1985; 92(9):1191–6.
6.   Klein R, Klein BEK, Moss SE. Visual Impairment in Diabetes. Ophthalmology. 1984; 91(1):1–9.
7.   Patel JI, Hykin PG, Cree IA. Diabetic cataract removal: postoperative progression of maculopathy growth factor and clinical analysis. Br J Ophthalmol. 2006; 90(6):697–701.
8.   Jurecka T, Bátková Z, Ventruba J, Synek S. [Macular edema after cataract surgery in diabetic patients without retinopathy]. Cesk Slov Oftalmol. 2007; 63(4):274–84.
9.   Chew EY, Benson WE, Remaley NA, Lindley AA, Burton TC, Csaky K, et al. Results after lens extraction in patients with diabetic retinopathy: early treatment diabetic retinopathy study report number 25. Arch Ophthalmol. 1999; 117(12):1600–6.
10. Dowler JG, Sehmi KS, Hykin PG, Hamilton AM. The natural history of macular edema after cataract surgery in diabetes. Ophthalmology. 1999; 106(4):663–8.
11. Squirrell D, Bhola R, Bush J, Winder S, Talbot JF. A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes.Br J Ophthalmol. 2002; 86(5):565–71.
12. Minckler D, Astorino A, Hamilton AMP. Cataract surgery in patients with diabetes. Ophthalmology. 1998; 105(6):949–50.
13. Mastropasqua R, Di Antonio L, Di Staso S, Agnifili L, Di Gregorio A, Ciancaglini M, et al. Optical Coherence Tomography Angiography in Retinal Vascular Diseases and Choroidal Neovascularization [Internet]. Journal of Ophthalmology. 2015
14. Marduel R. Angio OCT, Dye Less Angiography, A New Approach of Age Related Macular Degeneration (ARMD). Advances in Ophthalmology & Visual System. 2015; 2.
15. Sharma P, Sridhar J, Rayess N, Maguire JI. Optical coherence tomography angiography (OCT-A) of type 2 retinal arteriovenous malformation. Can J Ophthalmol. 2015; 50(5):e93-96.
16. Schwartz DM, Fingler J, Kim DY, Zawadzki RJ, Morse LS, Park SS, et al. Phase-variance optical coherence tomography: a technique for noninvasive angiography. Ophthalmology. 2014; 121(1):180–7.
17. Maloca P, Gyger C, Hasler PW. A pilot study to image the vascular network of small melanocytic choroidal tumors with speckle noise-free 1050-nm swept source optical coherence tomography (OCT choroidal angiography). Graefes Arch Clin Exp Ophthalmol. 2016; 254(6):1201-10.
18. Zeimer M, Gutfleisch M, Heimes B, Spital G, Lommatzsch A, Pauleikhoff D. Association between Changes in Macular Vasculature in Optical Coherence Tomography- and Fluorescein- Angiography and Distribution of Macular Pigment in Type 2 Idiopathic Macular Telangiectasia. Retina. 2015; 35(11): 2307–2316.
19. Degenring RF, Vey S, Kamppeter B, Budde WM, Jonas JB, Sauder G. Effect of uncomplicated phacoemulsification on the central retina in diabetic and non-diabetic subjects. Graefes Arch ClinExpOphthalmol. 2007; 245(1):18–23.
20. Katsimpris JM, Petropoulos IK, Zoukas G, Patokos T, Brinkmann CK, Theoulakis PE. Central foveal thickness before and after cataract surgery in normal and in diabetic patients without retinopathy. Klin Monbl Augenheilkd. 2012; 229(4):331–7.
21. Dimitrova G, Chihara E, Takahashi H, Amano H, Okazaki K. Quantitative Retinal Optical Coherence Tomography Angiography in Patients With Diabetes Without Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2017; 58(1):190–6.
22. Kim AY, Chu Z, Shahidzadeh A, Wang RK, Puliafito CA, Kashani AH. Quantifying Microvascular Density and Morphology in Diabetic Retinopathy Using Spectral-Domain Optical Coherence Tomography Angiography. Invest Ophthalmol Vis Sci. 2016; 57(9):OCT362-370.
23. Eladawi N, Elmogy M, Khalifa F, Ghazal M, Ghazi N, Aboelfetouh A, et al. Early diabetic retinopathy diagnosis based on local retinal blood vessel analysis in optical coherence tomography angiography (OCTA) images. Med Phys. 2018; 45(10):4582–99.
24. Ishibazawa A, Nagaoka T, Takahashi A, Omae T, Tani T, Sogawa K, et al. Optical Coherence Tomography Angiography in Diabetic Retinopathy: A Prospective Pilot Study. Am J Ophthalmol. 2015; 160(1):35-44.e1.