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Ocular Microvascular Changes in Offspring Born to Mothers With Gestational Diabetes Mellitus: The Nanjing Eye Study
Shiya Shen1, Xiaoqi Zhu1, Wen Chen2
1Department of Ophthalmology, the First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Insights
Children born to mothers with gestational diabetes mellitus (GDM) show altered ocular microvasculature. GDM exposure is linked to increased deep vascular complex vessel density and reduced choriocapillaris perfusion in offspring.
Area of Science:
- Ophthalmology
- Pediatrics
- Vascular Biology
Background:
- Gestational diabetes mellitus (GDM) is a growing concern affecting maternal and fetal health.
- The long-term impact of GDM on offspring's ocular development is not fully understood.
- Ocular microvasculature plays a critical role in visual function and development.
Purpose of the Study:
- To investigate microvascular differences in the macular retina and choriocapillaris (CC) of children exposed to maternal GDM compared to unexposed controls.
- To assess the potential long-term effects of GDM on the ocular vasculature of offspring.
Main Methods:
- A population-based cross-sectional study (Nanjing Eye Study) involving 7-year-old children.
- Ocular microvasculature was assessed using optical coherence tomography angiography (OCTA).
- Generalized linear models were used to analyze associations between maternal GDM and OCTA parameters, adjusting for confounders.
Main Results:
- Offspring exposed to maternal GDM exhibited significantly increased vessel density (VD) in the deep vascular complex (DVC) of the parafoveal temporal quadrant.
- Children exposed to GDM showed larger size and area of CC flow voids, indicating reduced choriocapillaris perfusion.
- No significant differences were found in superficial vascular complex VD, foveal avascular zone, macular thickness, or subfoveal choroidal thickness.
Conclusions:
- Maternal GDM exposure is associated with decreased choriocapillaris perfusion and increased DVC vessel density in offspring.
- These findings suggest a potential impact of GDM on the ocular microvasculature of children.
- Increased attention to eye development in GDM offspring is warranted.
Purpose:
To evaluate the microvascular differences in macular retina and choriocapillaris (CC) between offspring born to mothers with gestational diabetes mellitus (GDM) and unexposed controls.
Methods:
This population-based cross-sectional study was based on the Nanjing Eye Study. Children 7 years old completed detailed ocular examinations in 2019. Quantitative parameters of ocular microvasculature in the macular region were assessed using optical coherence tomography angiography (OCTA) and information about pregnancy and birth history was obtained from a comprehensive questionnaire. Generalized linear models were performed to assess associations between maternal GDM and ocular OCTA parameters adjusted for confounding factors.
Results:
A total of 681 children (mean age ± SD, 7.44 ± 0.27 years) had complete eye examination and questionnaire data, among whom 41 (6.0%) were born to mothers with GDM. In generalized linear models, offspring exposed to maternal GDM had significantly increased vessel density (VD) of the deep vascular complex (DVC) in the parafoveal temporal quadrant (difference = 1.238, P = 0.025), larger size of CC flow voids (difference = 0.134, P = 0.040), and larger area of CC flow voids (difference = 0.558, P = 0.018) compared with unexposed offspring. No significant differences were observed between the two groups in VD of superficial vascular complex, foveal avascular zone, macular thickness, or subfoveal choroidal thickness (all P > 0.05).
Conclusions:
Our data showed that GDM offspring have decreased CC perfusion and increased VD of DVC compared with normal peers. These findings suggest that GDM has a potential effect on ocular microvasculature in offspring.
Translational Relevance:
This study indicates that greater attention should be paid to eye growth and development in GDM offspring.
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