Abstract
Purpose In this study, the changes in microvascular circulation caused by
pregestational and gestational diabetes were observed, without focusing on
retinal findings, to reveal the effect of diabetes regulation.
Methods A total of 135 subjects were included: 30 with gestational
diabetes (GDM), 30 pregestational diabetes (PGDM), 30 healthy pregnant
normoglycemic subjects, and 45 healthy non-pregnant subjects. All subjects were
examined by optical coherence tomography (OCT) and angiography. The retina,
retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), choroidal thickness
(CT), superficial capillary plexus (SCP), deep capillary plexus (DCP),
choriocapillaris (CC), vascular density (VD), and foveal avascular zone (FAZ)
areas were measured.
Results The foveal VD of SCP and DCP was significantly lower in the PGDM
and GDM groups compared to the control groups (p:0.006 and p:0.001,
respectively). CC VD was significantly higher in all pregnant groups compared to
non-pregnant controls (p<0.001). The choroidal thickness values were highest
in the healthy pregnant group and lowest in the PGDM group. There was no
significant difference in FAZ area, retina, RNFL and GCL thickness between the
groups. In the PGDM group, a negative correlation was observed between the FAZ
area and the HbA1c level (r:− 0.417, p:0.043).
Conclusion There was a decrease in vascular density in pregnant women with
diabetes compared to healthy pregnant women and controls. In the pregnant group
with PGDM, a narrowing of the FAZ area was observed with increasing worsening of
diabetes control. Diabetes type and glycemic control could influence the
microvascular changes even in the absence of clinical or retinal findings.
Keywords foveal avascular zone area - gestational diabetes mellitus - optical coherence tomography angiography - pregestational diabetes mellitus - retinal capillary - vascular density
