The correlation of folic acid and homocysteine serum with vascular density and retinal non-perfusion area in diabetic retinopathy

  • Andhika Guna Dharma Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
  • Arief Wildan Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
  • Maharani Maharani Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
  • Riski Prihatningtias Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
  • Fifin Luthfia Rahmi Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
  • Trilaksana Nugroho Ophthalmology Department Diponegoro University/ DR Kariadi Hospital, Semarang
  • Arnila Novitasari Saubig Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
  • Zahira Rikiandraswida Faculty of Medicine, Diponegoro University, Semarang
Keywords:
Folic acid
Homocysteine
Vascular density
non-perfusion area
Diabetic Retinopathy

Abstract

Background : Diabetic Retinopathy (DR) is the most common microvascular complication of Diabetes Mellitus (DM). Homocysteine has been studied as a biomarker in DR, while folic acid exhibits anti-proliferative effects in DR. Objective : To analyze the correlation between folic acid and homocysteine serum with vascular density and retinal non-perfusion area in healthy individuals and patients with diabetic retinopathy. Methods : This is an observational study with a cross-sectional design, conducted in Dr. Kariadi Hospital and GAKI laboratory in Semarang in January 2023. This study included 60 samples: 15 healthy individuals, 15 patients with DM but no DR, 15 patients with Non-Proliferative Diabetic Retinopathy (NPDR), and 15 patients with Proliferative Diabetic Retinopathy (PDR). Patients were examined for serum folic acid and homocysteine using blood laboratory tests, vessel density and retinal non-perfusion areas using optical coherence tomography angiography (OCTA). Results : There was a negative correlation with weak strength between folic acid levels and retinal non-perfusion area of the retina in all samples (Folic acid levels vs retinal non-perfusion area, p = 0.009, Spearman correlation = -0.335). There was a positive correlation with weak strength between folic acid levels and vascular density in all samples (Folic acid levels vs vascular density, p = 0.009, Spearman correlation = 0.337). There was a positive correlation with moderate strength between homocysteine levels and retinal non-perfusion area in all samples (Homocysteine levels vs non–perfusion area of the retina, p = 0.001, Spearman correlation = 0.426). There was a positive correlation with moderate strength between homocysteine levels and vascular density in all samples (Homocysteine levels vs vascular density, p = 0.001, Spearman correlation = -0.414). Conclusion : There was a correlation between folic acid and homocysteine serum with vascular density and retinal non-perfusion areas.

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Author Biographies

Andhika Guna Dharma, Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
Ophthalmology Department
Arief Wildan, Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
Ophthalmology Department
Maharani Maharani, Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
Ophthalmology Department
Riski Prihatningtias, Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
Ophthalmology Department
Fifin Luthfia Rahmi, Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
Ophthalmology Department
Arnila Novitasari Saubig, Faculty of Medicine, Diponegoro University/ DR Kariadi Hospital, Semarang
Ophthalmology Department
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Submitted

2023-11-12
Accepted
2024-01-04
Published
2024-02-29