The impairment of the deep vascular complex in prolonged type 2 diabetes patients without clinical diabetic retinopathy

• Published in: PloS one Vol. 17; no. 6; p. e0269182
• Main Authors: Kim, Tae-Yeon, Song, Yong-Yeon, Il-Jung, Na, Yong-Jin, Lee, Young-Hoon, Kim, Jung-Yeul, Lee, Min-Woo
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03-06-2022; Public Library of Science (PLoS)
• Subjects: Automation; Biology and Life Sciences; Blood pressure; Blood-vessels; Complications and side effects; Demographics; Development and progression; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetic angiopathies; Diabetic retinopathy; Disease; Eye; Hospitals; Hypertension; Impairment; Ischemia; Medicine and Health Sciences; Microcirculation disorders; Microvasculature; Patients; Regression analysis; Retina; Retinopathy; Risk factors; Social Sciences; Statistical analysis; Tomography; Type 2 diabetes; South Korea; United States > US; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0269182

To identify the effects of prolonged type 2 diabetes (T2DM) on the retinal microvasculature of each retinal capillary plexus in patients without clinical diabetic retinopathy (DR).
Subjects were divided into three groups: the control group (98 eyes), patients with T2DM < 10 years (DM group 1, 84 eyes), and patients with T2DM ≥ 10 years (DM group 2, 55 eyes). The vessel densities (VD) of the superficial and deep capillary plexus (SCP and DCP) were compared. Linear regression analyses were performed to identify factors associated with the VD.
The mean VDs of the SCP in the control group, DM group 1, and DM group 2 were 35.9 ± 4.2, 34.9 ± 3.9, and 34.6 ± 5.1, respectively (P = 0.042). The mean VDs of the DCP in the three groups were 36.1 ± 3.1, 35.9 ± 3.0, and 34.0 ± 3.3, respectively (P < 0.001). In multivariate analyses, the BCVA was a significant factor associated with both the superficial VD (B = -7.10, P = 0.019) and deep VD (B = -5.70, P = 0.039). Hypertension (B = -1.22, P = 0.021) and DM duration (B = -0.20, P < 0.001) were significant factors associated with deep VD.
T2DM patients without DR showed decreased VD in the SCP and DCP. The microvascular impairment of the DCP in patients with T2DM ≥ 10 years was in particular, more severe. Additionally, ischemia caused by hypertension and accumulated impairment of microvasculature due to prolonged T2DM would affect the DCP.