Purpose To evaluate the longitudinal rate of choriocapillaris flow deficits (CFD) in healthy participants and patients with diabetes mellitus. Methods This prospective cohort study included healthy individuals and diabetic patients without diabetic retinopathy (non-DR) or with mild-to-moderate non-proliferative DR (NPDR). The swept-source optical coherence tomography angiography (OCTA) was adopted for quantifying CFD annually, and linear mixed models were used to analyse the CFD change and its 95% CI overtime. Results A total of 1025 individuals were included, including 465 healthy controls, 454 in the non-DR group and 106 in the NPDR group. Significant increase in CFDs was observed in NPDR group (0.423%, 95% CI 0.230% to 0.616%) and non-DR group (0.319%, 95% CI 0.225% to 0.412%), which were higher than the CFD in healthy controls (0.173%, 95% CI 0.079% to 0.266%). After adjusting for other factors, the non-DR and NPDR group had a greater annual elevation of CFD by 0.171% (95% CI 0.060% to 0.283%; p=0.003) and 0.258% (95% CI 0.068% to 0.449%; p=0.008) in comparisons with controls. Furthermore, higher serum creatinine and glycated haemoglobin levels, poorer best-corrected visual acuity, lower OCTA image quality scores and smaller CFD at baseline were independently related to accelerated CFD worsening (all p<0.05). Conclusions The CFD among healthy individuals and patients with diabetes increased consistently overtime, regardless of the presence or absence of DR, suggesting that CFD alterations could be an early indicator of microvascular complications, potentially aiding in the earlier DR detection. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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健康个体和糖尿病患者的脉络膜毛细血管灌注轨迹：一项前瞻性队列研究


目的 评估健康参与者和糖尿病患者脉络膜毛细血管血流缺陷 (CFD) 的纵向发生率。方法 这项前瞻性队列研究包括健康个体和没有糖尿病视网膜病变（非 DR）或患有轻至中度非增殖性 DR（NPDR）的糖尿病患者。每年采用扫源光学相干断层扫描血管造影（OCTA）对CFD进行量化，并使用线性混合模型分析CFD随时间的变化及其95％CI。结果共纳入1025人，其中健康对照者465人，非DR组454人，NPDR组106人。 NPDR组（0.423％，95％CI 0.230％至0.616％）和非DR组（0.319％，95％CI 0.225％至0.412％）CFD显着增加，高于健康对照的CFD （0.173%，95% CI 0.079% 至 0.266%）。调整其他因素后，非 DR 和 NPDR 组的 CFD 年升高幅度更大，分别为 0.171%（95% CI 0.060% 至 0.283%；p=0.003）和 0.258%（95% CI 0.068% 至 0.449%；p=0.003）。 p=0.008）与对照相比。此外，较高的血清肌酐和糖化血红蛋白水平、较差的最佳矫正视力、较低的 OCTA 图像质量评分和基线时较小的 CFD 与 CFD 恶化加速独立相关（均为 p<0.05）。结论 无论是否存在 DR，健康个体和糖尿病患者的 CFD 都会随着时间的推移而持续增加，这表明 CFD 改变可能是微血管并发症的早期指标，可能有助于早期 DR 检测。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。