ALTERATIONS OF MACULAR RETINAL MICROCIRCULATION EXAMINED WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AFTER SWITCHING FROM ORAL HYPOGLYCEMICS TO INSULIN THERAPY IN PATIENTS WITH TYPE 2 DIABETES
Keywords:
type 2 diabetes diabetic retinopathy diabetic maculopathy oral hypoglycemics insulin blood vessel density OKTAAbstract
Aim: To assess the impact of insulin therapy in the initial period on blood vessels density in the area of the macula lutea, evaluated with optical coherence angiography (OCTA) in patients with type 2 diabetes.
Materials and methods: A prospective observational study including 21 patients with type 2 diabetes was conducted. In 4 examined eyes, a nonproliferative diabetic retinopathy form of diabetic retinopathy was present without diabetic macular edema, while the remaining examined eyes were without the presence of DR/DME. Patients had been treated only with oral hypoglycemic drugs before inclusion in the study, and all of them were prescribed insulin therapy at the time of enrollment in the study. The main investigated parameters were changes in the density of blood vessels in the superficial vascular plexus and deep vascular plexus (DVP) in the macular area measured by optical coherence angiography.
Results: Тhe density of blood vessels in the first month of starting insulin treatment showed a significant decrease, especially in the deep vascular plexus. Three months after the start of insulin therapy, a decrease in the blood vessels density in the superficial vascular plexus was noticed. All parameters showed a return to normal values after the sixth month. The average HBA1 levels showed better results after insulin therapy.
Conclusion: This study suggests that in the initial phase of insulin therapy compared to oral antidiabetic agents, changes in the density of the blood vascular network in the macular region were observed with no corresponding change in the visual acuity.
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