Ocular Microvascular Changes in Offspring Born to Mothers With Gestational Diabetes Mellitus: The Nanjing Eye Study.

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.