Changes in choroidal thickness and volume are related to urinary albumin excretion in type 2 diabetic patients without retinopathy

Farias, Lucas Brandolt; Lavinsky, Daniel; Benfica, Camila Zanella; Silva, Monica Oliveira da; Lavisnky, Jacó; Canani, Luís Henrique Santos

doi:10.2147/opth.s164195

Cited by 8 publications

(13 citation statements)

References 23 publications

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“…Farias et al studied type 2 diabetes patients with no or mild DR and found a thinner subfoveal and temporal choroid CT in the microalbuminuric groups (when compared with normoalbuminuric) and a thinner subfoveal, temporal, and nasal CT in the microalbuminuric group when compared with controls [24]. Farias observed that mean subfoveal and temporal CT was significantly reduced in the microalbuminuric group when compared with normoalbuminuric [12].…”

Section: Discussionmentioning

confidence: 99%

“…Poor control of factors influencing CT could be responsible for the conflicting results in the literature: axial length and refractive error, diurnal variation of CT, age (there is a decreased of subfoveal CT of approximately 3 microns per year of age), dehydration, and other systemic disease, that can affect choroidal vasculature like systemic hypertension [12,19,[25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…Larger prospective clinical studies are needed for more complete knowledge about the role of diabetic choroidopathy both in early pathogenesis of DR and in the disease progression. It remains unclear, though, whether diabetic choroidopathy is a predicting, modulating, or causative factor of DR [12]. OCT angiography (OCT-A) has been performed as a useful tool for evaluating retinal vascular abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…Microalbuminuria is an early marker of generalized endothelial damage, and it is associated with microvascular chronic complications in diabetic patients. Annually, 5%-10% of type 2 diabetes mellitus patients with microalbuminuria develop diabetic nephropathy, presenting an increased risk of developing DR [11,12].…”

Section: Introductionmentioning

confidence: 99%

“…e emergence of spectral-domain (SD) optical coherence tomography (OCT) systems and the enhanced depth imaging (EDI) mode has led to a more efficient observation and measurement of the choroid [12]. e purpose of this study was to compare choroidal thickness (CT) in nondiabetic patients and in type 2 diabetic patients without retinopathy, using EDI SD-OCT. Additionally, considering the diabetic patient group, we compared CT in patients with and without microalbuminuria.…”

Section: Introductionmentioning

confidence: 99%

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Choroidal Thickness and Urinary Albumin Excretion in Type 2 Diabetic Patients without Retinopathy

Oliveira-Ferreira¹,

Leuzinger-Dias²,

Tavares-Ferreira³

et al. 2020

Journal of Ophthalmology

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The role of retinal vasculature’s dysfunction in the physiopathology of Diabetic Retinopathy (DR) has been extensively described. Recently, the existence of a diabetic choroidal vasculopathy has been proposed. The purpose of this study was to compare choroidal thickness (CT) in nondiabetic patients and in type 2 diabetic patients without retinopathy, using EDI SD-OCT. Additionally, considering the diabetic patient group, compare CT in patients with and without microalbuminuria. This retrospective study selected patients sent from primary health-care centers as part of the national screening of diabetic retinopathy. Inclusion criteria were diagnosis of type 2 diabetes mellitus, absence of diabetic retinopathy, and a 24 hours urinary albumin measurement in the last 3 months at the primary health-care center. Nondiabetic patients were selected from a database in the ophthalmology department, and only healthy patients were included. At the screening visit, all patients performed a complete ophthalmologic examination by the same examiner. All eyes were examined with SD- OCT, and all scans were performed in the EDI mode. Measurements were made at three points: subfoveal, 1500 μm temporally and nasally to the foveal center. We included 110 eyes of 110 diabetic patients without diabetic retinopathy and 30 eyes of 30 healthy controls. Mean subfoveal CT was greater in diabetic patients without retinopathy (with normoalbuminuria or microalbuminuria) when compared with nondiabetic patients (p<0.05). In diabetic patients without retinopathy, the subfoveal and temporal choroid was thicker among patients with microalbuminuria when compared with those of normoalbuminuric patients (p<0.05). The subfoveal and temporal choroid was thicker among diabetic patients with microalbuminuria compared with nondiabetic patients. (p<0.05). This study suggests that choroidal changes are present in type 2 diabetic patients even before the clinical development of retinopathy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Choroidal Thickness and Urinary Albumin Excretion in Type 2 Diabetic Patients without Retinopathy

Oliveira-Ferreira¹,

Leuzinger-Dias²,

Tavares-Ferreira³

et al. 2020

Journal of Ophthalmology

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Early choroidal changes detected by swept-source OCT in type 2 diabetes and their association with diabetic kidney disease

Silva

Chaves

Gobbato

et al. 2022

BMJ Open Diab Res Care

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IntroductionMicrovascular changes in eye and kidney shares some common factors in diabetes mellitus (DM). The purpose was to evaluate choroidal thickness (CT) and choriocapillaris (CC) density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT).Research design and methodsA cross-sectional study was conducted with patients with T2D with mild or no diabetic retinopathy (DR) and non-diabetic controls. CT was measured with SS-OCT, and CC vascular density was measured with OCT angiography. These parameters were compared with inner retinal layers thickness in patients with and without DKD and non-diabetic controls.ResultsNinety-three eyes from patients with T2D and 34 eyes from controls volunteers were included. Within the T2D group, 56 eyes with DKD and 37 eyes from patients with no diabetic kidney disease were examined. A statistically significant reduction of CT was observed in patients with DKD compared with controls, with no difference in CC density. There was an association between ganglion cell layer and central choroidal thickness reduction in the DKD group.ConclusionsPatients with T2D with DKD showed a decrease in CT with no difference in CC density compared with non-diabetic controls. This thinning might be related to vascular changes of choroidal layers such as Haller’s and Sattler’s with preservation of CC density, which is crucial for outer retina and retinal pigment epithelium health. Longitudinal studies are warranted to determine the association of choroidal changes with the pathogenesis of diabetes, and its association with early DKD and progression to more severe DR.

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Early choroidal and retinal changes detected by swept-source oct in type 2 diabetes and their association with diabetic kidney disease: a longitudinal prospective study

da Silva,

do Carmo Chaves,

Gobbato

et al. 2024

BMC Ophthalmol

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Background To evaluate structural changes in retina and choroid in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD). Methods T2D patients with mild or no diabetic retinopathy (DR) were followed for 3 years using structural SS-OCT and OCT angiography (OCT-A) taken every 6 months. Parameters were compared longitudinally and according to the DKD status on baseline. Results One hundred and sixty eyes from 80 patients were followed for 3 years, 72 with no DKD (nDKD) at baseline and 88 with DKD. Trend analysis of T2D showed significant thinning in GCL + and circumpapillary retinal fiber neural layer (cRFNL), choroid, and decreased vascular density (VD) in superficial plexus and central choriocapillaris with foveal avascular zone (FAZ) enlargement. Patients with no DKD on baseline presented more significant declines in retinal center and choroidal thickness, increased FAZ and loss of nasal and temporal choriocapillaris volume. In addition, the nDKD group had worse glycemic control and renal parameters at the end of the study. Conclusion Our data suggests the potential existence of early and progressive neurovascular damage in the retina and choroid of patients with Type 2 Diabetes (T2D) who have either no or mild Diabetic Retinopathy (DR). The progression of neurovascular damage appears to be correlated with parameters related to glycemic control and renal damage.

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Changes in choroidal thickness and volume are related to urinary albumin excretion in type 2 diabetic patients without retinopathy

Cited by 8 publications

References 23 publications

Choroidal Thickness and Urinary Albumin Excretion in Type 2 Diabetic Patients without Retinopathy

Choroidal Thickness and Urinary Albumin Excretion in Type 2 Diabetic Patients without Retinopathy

Early choroidal changes detected by swept-source OCT in type 2 diabetes and their association with diabetic kidney disease

Early choroidal and retinal changes detected by swept-source oct in type 2 diabetes and their association with diabetic kidney disease: a longitudinal prospective study

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