title: DETECTION OF MICROVASCULAR CHANGES IN EYES OF PATIENTS WITH DIABETES BUT NOT CLINICAL DIABETIC RETINOPATHY USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY.
abstract: OBJECTIVE
  To evaluate the ability of optical coherence tomography angiography to detect early microvascular changes in eyes of diabetic individuals without clinical retinopathy.
  
  
  METHODS
  Prospective observational study of 61 eyes of 39 patients with diabetes mellitus and 28 control eyes of 22 age-matched healthy subjects that received imaging using optical coherence tomography angiography between August 2014 and March 2015. Eyes with concomitant retinal, optic nerve, and vitreoretinal interface diseases and/or poor-quality images were excluded. Foveal avascular zone size and irregularity, vessel beading and tortuosity, capillary nonperfusion, and microaneurysm were evaluated.
  
  
  RESULTS
  Foveal avascular zone size measured 0.348 mm² (0.1085-0.671) in diabetic eyes and 0.288 mm² (0.07-0.434) in control eyes (P = 0.04). Foveal avascular zone remodeling was seen more often in diabetic than control eyes (36% and 11%, respectively; P = 0.01). Capillary nonperfusion was noted in 21% of diabetic eyes and 4% of control eyes (P = 0.03). Microaneurysms and venous beading were noted in less than 10% of both diabetic and control eyes. Both diabetic and healthy control eyes demonstrated tortuous vessels in 21% and 25% of eyes, respectively.
  
  
  CONCLUSIONS
  Optical coherence tomography angiography was able to image foveal microvascular changes that were not detected by clinical examination in diabetic eyes. Changes to the foveal avascular zone and capillary nonperfusion were more prevalent in diabetic eyes, whereas vessel tortuosity was observed with a similar frequency in normal and diabetic eyes. Optical coherence tomography angiography may be able to detect diabetic eyes at risk of developing retinopathy and to screen for diabetes quickly and noninvasively before the systemic diagnosis is made.
authors.affiliation: *Department of Ophthalmology, New England Eye Center and Tufts Medical Center, Tufts University, Boston, MA; †Department of Electrical Engineering and Computer Science, and Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA; and ‡CAPES Foundation, Ministry of Education of Brazil, Brasilia, Brazil.
authors.forename: Talisa E
authors.initials: TE
authors.lastname: de Carlo
authors.forename: Adam T
authors.initials: AT
authors.lastname: Chin
authors.forename: Marco A
authors.initials: MA
authors.lastname: Bonini Filho
authors.forename: Mehreen
authors.initials: M
authors.lastname: Adhi
authors.forename: Lauren
authors.initials: L
authors.lastname: Branchini
authors.forename: David A
authors.initials: DA
authors.lastname: Salz
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Baumal
authors.forename: Courtney
authors.initials: C
authors.lastname: Crawford
authors.forename: Elias
authors.initials: E
authors.lastname: Reichel
authors.forename: Andre J
authors.initials: AJ
authors.lastname: Witkin
authors.forename: Jay S
authors.initials: JS
authors.lastname: Duker
authors.forename: Nadia K
authors.initials: NK
authors.lastname: Waheed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods*; D006801:Humans; D008297:Male; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D011446:Prospective Studies; D012171:Retinal Vessels / Q000473:pathology*; D018570:Risk Assessment; D041623:Tomography, Optical Coherence / Q000379:methods*; D055815:Young Adult