Study of ocular microcirculation using optical coherence tomography–angiography in pregnant women suffering from diabetes mellitus

Purpose of the work was to investigate the state of ocular microcirculation using optical coherence tomography angiography (OCTA, Optovue RTVue XR Avanti, USA) in pregnant women with diabetes mellitus (DM).

Material and methods. The study included 113 pregnant women with DM and 60 healthy pregnant women (control group). 69 women with DM had diabetic retinopathy (DR): 49 had a progressive course and 20 had a stable course. In the superficial and deep retinal plexuses, OCTA was used to examine the vessel density indices, the area of the foveal avascular zone (FAZ), and the proportion of non-perfusion zones (our own method). The examination of patients with DM was performed in all trimesters and 3 months after delivery, and the control group was examined in the third trimester.

Results. All vessel density indices in patients with DM were significantly lower, and the proportion of non-perfusion zones in both plexuses was significantly higher (p < 0.001) than in the control group. During pregnancy and after delivery, patients with DR showed a progressive decrease in vascular density indices, an increase in PFAZ and the proportion of non-perfusion zones in both plexuses. To a greater extent, this was due to the dynamics of the studied parameters in the subgroup with DR progression.

Conclusion. The established patterns of changes in the parameters characterizing retinal blood flow during gestation and in the postpartum period in pregnant women with diabetes with stable and progressive DR can become the basis for predicting the nature of DR, facilitating early diagnosis of DR progression and determining indications for timely laser retina coagulation of such patients.

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