Obese Foveal Avascular Zone Assessed by Optical Coherence Tomography Angiography of the Retina: Is There a Relation to Comorbities?

Purpose: To investigate the foveal avascular zone (FAZ) in obese by optical coherence tomography angiography (OCT-A) and to evaluate the findings of structural optical coherence tomography (OCT) and their relations with comorbidities. Methods: It was included 35 obese (study group) and 30 normal individuals (control group). Patients with retinal diseases and retinal treatments were excluded. The images were obtained using the Topcon®;. Results: The mean areas of FAZ in superficial plexus (FAZ-SP) and deep plexus (FAZ-DP) were significantly greater in the study group: FAZ-SP was 405.0 ± 136.4 μm2 in the obese group and 307.3 ± 78.6 μm2 in the control group and in the left eye (LE) 477.1 ± 124.4 μm2 in the obese group and 384.0 ± 88.7 μm2 in the control group. This difference was statistically significant (RE: p = 0.0014 and LE: p = 0.0012). The mean area of the FAZ-DP was 491.0 ± 124.4 μm2 (Right eye—RE) in the obese group and 384.4 ± 88.7 μm2 in the control group and in the left eye (LE) was 497.9 ± 124.1 μm2 in the obese group and 484.9 ± 92.7 μm2 in the control group. There were no correlations regarding FAZ-SP and FAZ-DP in both eyes with fasting blood glucose, glycated hemoglobin, total cholesterol and fractions and triglycerides. A significant association between enlargement of FAZ-DP and type 2 diabetes mellitus (p = 0.0160) was observed. Conclusion: The FAZ areas in superficial and deep plexus achieved significantly greater values in the study group. There was a significant association between a larger deep FAZ area and type 2 diabetes mellitus. It is necessary an evaluation with a larger sample size to corroborate the findings.

Screening of Diabetic Retinopathy in Patients with Type 2 Diabetes in a Community of the Paraíba Semi-Arid Using Original Score

Introduction: Diabetic retinopathy (DR) is neglected in the planning of health services in Brazil. The purpose of this study was to investigate the frequency of Diabetic Retinopathy in patients with type 2 diabetes mellitus (DM2) registered in the Unified Health System (SUS) of the semi-arid of Paraíba (PB-Brazil), using a score developed by the researchers to track this condition. Methods: A cross-sectional study was carried out, in which DM2 patients registered at SUS in the city of S?o Mamede-PB was recruited. Ophthalmological and clinical data were collected, including: body mass index (BMI), waist circumference (WC), waist circumference/height ratio (WC/stature), smoking history, physical activity, time of diabetes and its control, blood pressure values and comorbidities. With these data, an original score for DR screening (DRSS) was performed. Qualitative variables were expressed by absolute and relative frequencies, and quantitative variables were expressed by means and standard deviations. p value ≤ 0.05 was used to reject the null hypothesis. Results: Ninety seven (64.7%) type 2 diabetic patients were recruited. Participants were predominantly women (64.9%), with a mean age of 65.8 years, of short stature (mean of 1.56 m), high BMI, with a predominance of the WC/stature ratio equal to or greater than 0.60, smokers and patients with systemic arterial hypertension (SAH). The main ophthalmological findings were: vascular changes compatible with Grade I/II Hypertensive Retinopathy (72.1%) and cataracts in about 50% of the eyes. The prevalence of DR was 12.4%. According to the DRSS results, it was found that most patients (85.6%) had a high risk score equal to or greater than 60 of developing DR. It was observed that the variables: WC, physical activity, time of diabetes and SAH showed a significant association with the risk of developing DR. In addition, BMI and WC/height ratio with higher values had a high risk of developing DR. Conclusion: There was association between medium and high DRSS risk diabetics with the probability of developing DR, recommending that all people with these characteristics should be referred to the specialist in order to screen for DR and other morbidities caused by diabetes.