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Hoel S, Moe K, Sugulle M, Petrovski G, Veiby NCBB, Staff AC. Retinal oximetry and microvascular assessment after hypertensive pregnancy complications. Acta Ophthalmol 2024. [PMID: 38342958 DOI: 10.1111/aos.16651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE Women with hypertensive disorders of pregnancy (HDP) are at increased risk of developing premature cardiovascular disease (CVD). The mechanisms behind this are not fully understood, but microvascular alterations have been documented in retinal arterioles and venules. The aim of this study was to use non-invasive retinal imaging to investigate the structural and functional properties of arterioles, venules and capillaries in this patient group. METHODS We examined 27 women with previous HDP and 23 controls at 3 years postpartum. The retinal microvasculature was assessed by vessel calibre measurements, retinal oximetry and optical coherence tomography angiography. Differences were analysed using non-parametric tests and multiple regression analyses, adjusted for age and body mass index. RESULTS Median arteriolar oxygen saturation (SaO2 ; 94.2% vs. 93.0%), venular oxygen saturation (SvO2 ; 60.1% vs. 62.4%) and arteriovenous saturation difference (AV-difference; 32.8% vs. 32.3%) were similar across groups. Capillary vessel density (VD; 46.2% vs. 46.3%), skeletonised VD (VSD; 21.3 vs. 21.1 mm/mm2 ) and vessel diameter index (21.65 vs. 21.86) were also comparable. In the HDP group, mean arterial pressure (MAP) was positively correlated with AV-difference (R2 = 0.209) and negatively correlated with arteriolar diameter (CRAE; r2 = 0.382). CONCLUSIONS Structural microvascular alterations appear not to be key biomarkers for CVD risk after HDP as early as 3 years postpartum in otherwise healthy women. Further studies are needed to evaluate whether such changes occur later in life. MAP was associated with AV-difference only in the HDP group, suggesting specific mechanisms affecting functional microvascular properties in these women.
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Affiliation(s)
- Sissel Hoel
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Kjartan Moe
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Meryam Sugulle
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Goran Petrovski
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Ophthalmology, Center for Eye Research and Innovative Diagnostics, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, University of Split School of Medicine and University Hospital Centre, Split, Croatia
- UKLONetwork, University St. Kliment Ohridski-Bitola, Bitola, North Macedonia
| | - Nina Charlotte B B Veiby
- Department of Ophthalmology, Center for Eye Research and Innovative Diagnostics, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
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Veiby NC, Simeunovic A, Heier M, Brunborg C, Saddique N, Moe MC, Dahl‐Jørgensen K, Petrovski G, Margeirsdottir HD. Retinal venular oxygen saturation is associated with non-proliferative diabetic retinopathy in young patients with type 1 diabetes. Acta Ophthalmol 2022; 100:388-394. [PMID: 34668632 DOI: 10.1111/aos.15018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/22/2021] [Accepted: 08/31/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the contribution of retinal vessel density (VD), central retinal vessel diameter and retinal oxygen (O2 ) saturation independently of other known risk factors in the development of non-proliferative diabetic retinopathy (NPDR). METHODS Macular optical coherence tomography angiography (OCTA), central retinal artery/vein equivalent diameter (CRAE/CRVE) measurements and retinal oximetry were performed in a cross-sectional study of 166 eyes from 166 individuals with type 1 diabetes (T1D) aged 14-30 years. Multiple logistic regression analysis was used to investigate whether O2 saturation, retinal vessel diameters and vessel density in the deep capillary plexus (VD-DCP) were associated with NPDR, when adjusting for known risk factors. The individuals were allocated to one group without and one group with NPDR. RESULTS Multiple logistic regression analysis showed that age (OR = 1.25, 95% CI: 1.04-1.49) and AV-difference in O2 saturation (OR = 0.85, 95% CI 0.77-0.93) were significantly associated with NPDR. CONCLUSION Our findings suggest that age and lower AV-O2 saturation difference contribute to explaining the grade of NPDR independently of other well-known risk factors. Reduced delivery of O2 to the retinal tissue is associated with the development of NPDR in young patients with T1D and should be given appropriate weight in the risk stratification at early stages of the disease.
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Affiliation(s)
- Nina C.B.B. Veiby
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Aida Simeunovic
- Department of Paediatrics and adolescent Medicine Akershus University Hospital Lorenskog Norway
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Martin Heier
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Cathrine Brunborg
- Oslo Centre of Biostatistics and Epidemiology Oslo University Hospital Oslo Norway
| | - Naila Saddique
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Morten C. Moe
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
| | - Knut Dahl‐Jørgensen
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
| | - Goran Petrovski
- Center for Eye Research Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway
| | - Hanna D. Margeirsdottir
- Department of Paediatrics Oslo University Hospital Oslo Norway
- Oslo Diabetes Research Centre Oslo Norway
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Drobnjak Nes D, Berg-Hansen P, de Rodez Benavent SA, Høgestøl EA, Beyer MK, Rinker DA, Veiby N, Karabeg M, Petrovski BÉ, Celius EG, Harbo HF, Petrovski G. Exploring Retinal Blood Vessel Diameters as Biomarkers in Multiple Sclerosis. J Clin Med 2022; 11:jcm11113109. [PMID: 35683496 PMCID: PMC9181486 DOI: 10.3390/jcm11113109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/12/2022] Open
Abstract
We aimed to determine whether retinal vessel diameters and retinal oxygen saturation in newly diagnosed patients with multiple sclerosis (pwMS) are different from those of a healthy population. Retinal blood vessel diameters were measured using imaging with a spectrophotometric non-invasive retinal oximeter. Twenty-three newly diagnosed untreated relapsing-remitting MS (RRMS) patients (mean age: 32.2 ± 7.5 years, age range = 18-50 years, 56.5% female) were measured and compared to 23 age- and sex-matched healthy controls (HCs) (mean age: 34.8 ± 8.1 years). Patients with Optic Neuritis were excluded. Retinal venular diameter (143.8 µm versus 157.8 µm: mean; p = 0.0013) and retinal arteriolar diameter (112.6 µm versus 120.6 µm: mean; p = 0.0089) were smaller in pwMS when compared with HCs, respectively. There was no significant difference in the oxygen saturation in retinal venules and arterioles in pwMS (mean: 60.0% and 93.7%; p = 0.5980) compared to HCs (mean: 59.3% and 91.5%; p = 0.8934), respectively. There was a significant difference in the median low contrast visual acuity (2.5% contrast) between the pwMS and the HC groups (p = 0.0143) Retinal arteriolar and venular diameter may have potential as objective biomarkers for MS.
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Affiliation(s)
- Dragana Drobnjak Nes
- Center of Eye Research, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway; (D.D.N.); (S.A.d.R.B.); (N.V.); (M.K.)
| | - Pål Berg-Hansen
- Department of Neurology, Oslo University Hospital, 0372 Oslo, Norway; (P.B.-H.); (E.A.H.); (D.A.R.); (E.G.C.); (H.F.H.)
| | - Sigrid A. de Rodez Benavent
- Center of Eye Research, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway; (D.D.N.); (S.A.d.R.B.); (N.V.); (M.K.)
| | - Einar A. Høgestøl
- Department of Neurology, Oslo University Hospital, 0372 Oslo, Norway; (P.B.-H.); (E.A.H.); (D.A.R.); (E.G.C.); (H.F.H.)
- Department of Psychology, University of Oslo, 0373 Oslo, Norway
| | - Mona K. Beyer
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0379 Oslo, Norway
| | - Daniel A. Rinker
- Department of Neurology, Oslo University Hospital, 0372 Oslo, Norway; (P.B.-H.); (E.A.H.); (D.A.R.); (E.G.C.); (H.F.H.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
| | - Nina Veiby
- Center of Eye Research, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway; (D.D.N.); (S.A.d.R.B.); (N.V.); (M.K.)
| | - Mia Karabeg
- Center of Eye Research, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway; (D.D.N.); (S.A.d.R.B.); (N.V.); (M.K.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
| | - Beáta Éva Petrovski
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
| | - Elisabeth G. Celius
- Department of Neurology, Oslo University Hospital, 0372 Oslo, Norway; (P.B.-H.); (E.A.H.); (D.A.R.); (E.G.C.); (H.F.H.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
| | - Hanne F. Harbo
- Department of Neurology, Oslo University Hospital, 0372 Oslo, Norway; (P.B.-H.); (E.A.H.); (D.A.R.); (E.G.C.); (H.F.H.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
| | - Goran Petrovski
- Center of Eye Research, Department of Ophthalmology, Oslo University Hospital, 0450 Oslo, Norway; (D.D.N.); (S.A.d.R.B.); (N.V.); (M.K.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway; (M.K.B.); (B.É.P.)
- Correspondence:
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Mlčák P, Chlup R, Kudlová P, Krystyník O, Král M, Kučerová V, Spurná J, Titzová S, Hübnerová P, Vláčil O, Šínová I, Karhanová M, Zapletalová J, Šín M. Retinal oxygen saturation is associated with HbA1c but not with short-term diabetes control, internal environment, smoking and mild retinopathy - ROXINEGLYD study. Acta Ophthalmol 2022; 100:e142-e149. [PMID: 33742561 DOI: 10.1111/aos.14853] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 01/20/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Purpose of this prospective uncontrolled single-centre pilot study was to find an association of retinal oxygen saturation (SatO2 ) with acid-base balance (ABB), carboxyhaemoglobin concentration, current plasma glucose concentration (PG), mean PG and PG variability over the last 72 hr, haemoglobin A1c (HbA1c), and other conditions. METHODS Forty-one adults (17 men) with type 1 (N = 14) or type 2 (N = 27) diabetes mellitus, age 48.6 ± 13.5 years, diabetes duration 9 (0.1-36) years, BMI 29.4 ± 6.3 kg/m2 , and HbA1c 52 ± 12.7 mmol/mol completed the study. The 4-day study comprised two visits (Day l, Day 4) including 72 hr of continuous glucose monitoring (CGM) by iPro® 2 Professional CGM (Medtronic, MiniMed, Inc., Northridge, CA, USA). Retinal oximeter Oxymap T1 (Oxymap ehf., Reykjavik, Iceland) was used to assess SatO2 . RESULTS Wilcoxon signed-rank test showed no SatO2 difference between eyes and visits. Spearman's correlation analysis revealed a significant correlation between arterial SatO2 and PG variability in type 2 diabetes mellitus, a positive correlation of venous SatO2 with HbA1c and with finger pulse oximetry. However, no correlation of SatO2 with ABB, carboxyhaemoglobin, current PG, mean PG over the 72 hr, age, diabetes duration, BMI, lipoproteinaemia, body temperature, systolic and diastolic blood pressure, heart rate, central retinal thickness and retinal nerve fibre layer thickness was found. CONCLUSION This study confirmed the association of venous SatO2 with long-term but not with short-term diabetes control, ABB and other conditions. The increased SatO2 and questionable impact of PG variability on retinal SatO2 is a research challenge.
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Affiliation(s)
- Petr Mlčák
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Rudolf Chlup
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
- Department of Internal Medicine II – Gastroenterology and Hepatology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Pavla Kudlová
- Department of Health Sciences Faculty of Humanities Tomáš Baťa University Zlín Zlín Czech Republic
| | - Ondřej Krystyník
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Michal Král
- Department of Neurology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Veronika Kučerová
- Department of Clinical Biochemistry University Hospital Olomouc Olomouc Czech Republic
| | - Jaromíra Spurná
- Department of Internal Medicine III – Nephrology, Rheumatology and Endocrinology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Simona Titzová
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Petra Hübnerová
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
- Department of Physiology Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Ondřej Vláčil
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Irena Šínová
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Marta Karhanová
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Jana Zapletalová
- Department of Medical Biophysics Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
| | - Martin Šín
- Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic
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Weisner G, Blindbæk SL, Tang FY, Cheung CY, Henriksen JE, Stefánsson E, Peto T, Grauslund J. Non-invasive structural and metabolic retinal markers of disease activity in non-proliferative diabetic retinopathy. Acta Ophthalmol 2021; 99:790-796. [PMID: 33416216 DOI: 10.1111/aos.14761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 01/15/2023]
Abstract
PURPOSE Metabolic and structural microvascular retinal alterations are essential components in diabetic retinopathy (DR). The present study aimed to measure changes at different stages of non-proliferative DR (NPDR) and to explore interactions of imaging-based metrics. METHODS This cross-sectional, cohort study included 139 eyes from 80 diabetic patients. Each patient underwent dilated fundal examinations including colour fundus photography, retinal oximetry and optical coherence tomography angiography (OCTA), analysed by semi-automated and automated software. Diabetic retinopathy (DR) severity was classified according to the International Clinical Diabetic Retinopathy (ICDR) Severity Scale, ranging from no DR to severe NPDR (level 0-3). Retinal metabolism was evaluated by oximetry as retinal arteriolar (raSatO2 ) and venular oxygen saturation (rvSatO2 ), and macular microvascular structure was measured by OCTA as the area of foveal avascular zone (FAZ), vessel density (VD), vessel diameter index (VDI), FAZ circularity and fractal dimension (FD) in the superficial and deep retinal capillary plexus. RESULTS A trend for increasing rvSatO2 was found with increasing DR severity (51.3%, 53.3%, 54.2%, 59.8%, p = 0.02). Increasing severity of DR associated with decreasing FD in the superficial and deep plexus (p < 0.001 and p = 0.014), and in the superficial plexus decreasing VD (p < 0.001), increasing VDI (p = 0.003) and decreasing FAZ circularity (p = 0.006). A few interactions were identified between raSatO2 , rvSatO2 and VDI, but only in the deep capillary plexus (p < 0.01 and p < 0.01). CONCLUSION Alterations of the venular retinal vascular oxygen saturation and microvascular structural abnormities were found continuously throughout the DR-spectrum. Given the sparse correlations between metabolic and structural abnormalities, it seems that these occur independently in DR.
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Affiliation(s)
- Gwen Weisner
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Centre for Public Health Queen’s University Belfast Belfast UK
- OPEN, Open Patient data Explorative Network Odense University Hospital Odense Denmark
| | - Søren Leer Blindbæk
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Fang Yao Tang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong China
| | - Jan Erik Henriksen
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Steno Diabetes Center Odense Odense University Hospital Odense Denmark
| | - Einar Stefánsson
- University of Iceland Reykjavik Iceland
- Landspitali University Hospital Reykjavik Iceland
| | - Tunde Peto
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Centre for Public Health Queen’s University Belfast Belfast UK
| | - Jakob Grauslund
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Department of Clinical Research University of Southern Denmark Odense Denmark
- Steno Diabetes Center Odense Odense University Hospital Odense Denmark
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Veiby NCBB, Simeunovic A, Heier M, Brunborg C, Saddique N, Moe MC, Dahl-Jørgensen K, Margeirsdottir HD, Petrovski G. Associations between Macular OCT Angiography and Nonproliferative Diabetic Retinopathy in Young Patients with Type 1 Diabetes Mellitus. J Diabetes Res 2020; 2020:8849116. [PMID: 33313325 PMCID: PMC7721511 DOI: 10.1155/2020/8849116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/15/2020] [Accepted: 11/13/2020] [Indexed: 12/26/2022] Open
Abstract
METHODS OCTA of both eyes was performed in a cross-sectional study of 14 to 30-year-old individuals with at least 10-year duration of T1D and controls recruited from the Norwegian Atherosclerosis and Childhood Diabetes (ACD) study. Vessel density (VD) and foveal avascular zone (FAZ) area in the superficial and deep capillary plexus (SCP and DCP), total retinal volume (TRV), and central macular thickness (CMT) were calculated using automated software. Univariate and multivariate ordered logistic regression (OLR) models were used accordingly. RESULTS We included 168 control eyes and 315 T1D eyes. Lower VD in DCP (OR 0.65, 95% CI 0.51-0.83), longer diabetes duration (OR 1.51, 95% CI 1.22-1.87), and higher waist circumference (OR 1.08, 95% CI 1.02-1.14) were significantly associated with progression of NPDR. VD in SCP and DCP were significantly lower in T1D patients without diabetic retinopathy than in controls. CONCLUSIONS Sparser VD in DCP is significantly associated with severity of NPDR, supporting that OCTA might detect the earliest signs of NPDR before it is visible by ophthalmoscopy.
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Affiliation(s)
- Nina C B B Veiby
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital, 0407 Oslo, Norway
| | - Aida Simeunovic
- Department of Paediatrics and Adolescent Medicine, Akershus University Hospital, 1474 Lorenskog, Norway
- Department of Paediatric Medicine, Oslo University Hospital, 0407 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
- Oslo Diabetes Research Centre, 0284 Oslo, Norway
| | - Martin Heier
- Department of Paediatric Medicine, Oslo University Hospital, 0407 Oslo, Norway
- Oslo Diabetes Research Centre, 0284 Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, 0372 Oslo, Norway
| | - Naila Saddique
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital, 0407 Oslo, Norway
| | - Morten C Moe
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital, 0407 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
| | - Knut Dahl-Jørgensen
- Department of Paediatric Medicine, Oslo University Hospital, 0407 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
- Oslo Diabetes Research Centre, 0284 Oslo, Norway
| | - Hanna D Margeirsdottir
- Department of Paediatric Medicine, Oslo University Hospital, 0407 Oslo, Norway
- Oslo Diabetes Research Centre, 0284 Oslo, Norway
| | - Goran Petrovski
- Center for Eye Research, Department of Ophthalmology, Oslo University Hospital, 0407 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
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