Analysis of Morphological Features and Vascular Layers of Choroid in Diabetic Retinopathy Using Spectral-Domain Optical Coherence Tomography

Adhi, Mehreen; Brewer, Erika; Waheed, Nadia K.; Duker, Jay S.

doi:10.1001/jamaophthalmol.2013.4321

Cited by 179 publications

(158 citation statements)

References 35 publications

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“…The most plausibly contributory factor is previous photocoagulation; studies including eyes treated with pan retinal photocoagulation (PRP) generally report reduced choroidal thickness in PDR. 5,11,17 Although PRP appears to initially increase choroidal thickness, over time it leads to choroidal thinning. 8,18,19 A further study of 63 diabetic eyes with NPDR also found overall choroidal thinning.…”

Section: Discussionmentioning

confidence: 99%

“…Thus far, histological analysis has shown increased tortuosity, focal vascular dilations and narrowing, capillary dropout, and scarring in DR. 3,4 Spectral domain optical coherence tomography (SD-OCT) has recently been used to examine choroidal morphology, revealing an irregular shape to the choroidoscleral interface. 5 The development of enhanced depth imaging (EDI) SD-OCT has improved visualisation of the choroid with high resolution cross-sectional imaging, enabling reliable and reproducible measurements of full choroidal thickness. 6,7 Although there have been a few small studies measuring choroidal thickness in diabetic patients, not all have used EDI-OCT imaging and the relationship between choroidal thickness and progression of DR remains unclear with reports of both a thicker 8,9 and a thinner choroidal layer in diabetic subjects.…”

Section: Introductionmentioning

confidence: 99%

“…6,7 Although there have been a few small studies measuring choroidal thickness in diabetic patients, not all have used EDI-OCT imaging and the relationship between choroidal thickness and progression of DR remains unclear with reports of both a thicker 8,9 and a thinner choroidal layer in diabetic subjects. 5,[10][11][12][13] In addition, it is unknown whether diabetic macular oedema (DMO) influences the degree of choroidopathy with the above studies finding eyes with DMO to have choroidal layers thicker, thinner, and no different to controls. In patients with DR and DMO, we hypothesised that choroidal thickness would correlate more closely with DR, increasing with the severity.…”

Section: Introductionmentioning

confidence: 99%

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Subfoveal choroidal thickness in patients with diabetic retinopathy and diabetic macular oedema

Rewbury

Want

Varughese

et al. 2016

Eye

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subfoveal choroidal thickness in patients with diabetic retinopathy and diabetic macular oedema

Rewbury

Want

Varughese

et al. 2016

Eye

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“…Previous studies have reported abnormal choroidal findings in patients with diabetes such as increased blood vessel tortuosity, focal vascular dilation and narrowing, hypercellularity, vascular loops, microaneurysms, areas of non-perfusion, and sinus-like structure formation between the choroidal lobules (14,23) . Choroidal thinning, increased thickness of the extracellular matrix, and decreased vessel diameter have been observed on SD-OCT imaging in the eyes of patients with diabetes (16,24,25) . Anti-VEGF treatment has demonstrated utility in improving visual and anatomical outcomes in DME (4)(5)(6)(7)(8)(9)(10) .…”

Section: Discussionmentioning

confidence: 99%

Effect of intravitreal anti-VEGF on choroidal thickness in patients with diabetic macular edema using spectral domain OCT

Kniggendorf¹,

Novais²,

Kniggendorf³

et al. 2016

Arquivos Brasileiros De Oftalmologia

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Approved by the following research ethics committee: UNIFESP (#1.093.853). ABSTRACTPurpose: To evaluate choroidal thickness (CT) using spectral domain optical coherence tomography (SD-OCT) imaging at baseline and 6 months after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with diabetic macular edema (DME). Methods: A retrospective chart review was performed to identify patients with DME who underwent intravitreal injection of anti-VEGF (bevacizumab or ranibizumab) in a pro re nata (PRN) regimen. Subfoveal choroidal thickness was compared between values obtained at baseline and at 6-month follow-up visits. Results: Thirty-nine eyes (15 females, 24 males) from 39 patients were enrolled (mean age, 62.43 ± 8.7 years; range, 44-79 years). Twenty-three and 16 eyes were treated with ranibizumab and bevacizumab respectively. The mean number of anti-VEGF injections was 2.28 ± 1.27 (range, 1-5). Mean nasal, subfoveal, and temporal choroidal thickness (CT) measurements at baseline were 234.10 ± 8.63 μm, 246.89 ± 8.94 μm, and 238.12 ± 8.20 μm, respectively, and those at 6 months post-treatment were 210.46 ± 8.00 μm, 215.66 ± 8.29 μm, and 212.43 ± 8.14 μm, respectively. Significant differences in CT were observed between baseline and the 6-month follow-up at all measured points (p=0.0327). Conclusions: Over a 6-month period, the use of intravitreal anti-VEGF was associated with significant thinning of the choroid in patients with DME. The clinical significance of a thinner choroid in DME is currently unknown; however, it may contribute to long-term adverse effects on choroidal and retinal function, representing an area requiring future investigation.

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“…Recent studies applying SD-OCT to evaluate choroidal thickness (CT) in eyes with DME have demonstrated altered and inconsistent CT measurements. [2][3][4][5][6][7] One important explanation for these variable results is these studies include eyes that received treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, which has been shown to cause choroidal thinning. 3 Recently, baseline subfoveal CT was shown to help predict which patients with DME will respond more favorably in the short term to intravitreal anti-VEGF pharmacotherapy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of ocular pulse amplitude and choroidal thickness in diabetic macular edema

Totan

Akyüz

Güler

et al. 2015

Eye

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Purpose The aim of this study is to evaluate the ocular pulse amplitude (OPA) and choroidal thickness (CT) measurements in patients with diabetic macular edema (DME) and healthy subjects. Methods A total of 34 patients (12 male and 22 female) who had type 2 diabetes mellitus with DME and 34 sex-matched healthy subjects (13 male and 21 female) were included in this prospective study. The intraocular pressure (IOP) and OPA were measured with Dynamic contour tonometer (Pascal DCT, Switzerland). The subfoveal CT was measured using the Cirrus HD-OCT (Carl Zeiss Meditec). The CT at 1500 μm and 3000 μm nasal and temporal to the central fovea was also measured. Results The mean IOP values were 18.4 ± 3.5 and 17.1 ± 2.1 mm Hg in DME patients and healthy controls, respectively (P = 0.091). The mean OPA values in patients with DME (2.58 ± 0.96) and controls (3.52 ± 1.03) were statistically different (Po0.001). The mean subfoveal CT value was 273.5 ± 30.2 μm in the eyes with DME and 321.4 ± 36.5 μm in the control group (Po 0.001). In both groups, linear regression analysis showed no significant association between OPA and CT measurements. The IOP showed a significantly positive correlation with OPA in both DME (P = 0.002, r = 0.526) and controls (P = 0.004, r = 0.483). Conclusions The current study suggests that both pulsatile choroidal blood flow and CT are decreased in patients with DME.

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Analysis of Morphological Features and Vascular Layers of Choroid in Diabetic Retinopathy Using Spectral-Domain Optical Coherence Tomography

Cited by 179 publications

References 35 publications

Subfoveal choroidal thickness in patients with diabetic retinopathy and diabetic macular oedema

Subfoveal choroidal thickness in patients with diabetic retinopathy and diabetic macular oedema

Effect of intravitreal anti-VEGF on choroidal thickness in patients with diabetic macular edema using spectral domain OCT

Evaluation of ocular pulse amplitude and choroidal thickness in diabetic macular edema

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