Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography

Wang, Jay C.; Laíns, Inês; Providência, Joana; Armstrong, Grayson W.; Santos, Ana Rita; Gil, Pedro; Gil, João; Talcott, Katherine E.; Marques, João Heitor; Figueira, João; Vavvas, Demetrios G.; Kim, Ivana K.; Miller, Joan W.; Husain, Deeba; Silva, Rufino; Miller, John B.

doi:10.1016/j.ajo.2017.09.030

Cited by 72 publications

(69 citation statements)

References 42 publications

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“…Wang et al , in a prospective cross-sectional study of 233 eyes, used OCTA to compare CVD in diabetic eyes and controls and similarly found decreased choroidal vascular indices in patients with diabetes 10. Wang et al reported a 6% reduction in the average CVD in eyes with NPDR and 12% in eyes with PDR, while this research found that eyes with DR had a reduction of approximately 7.5% in the choriocapillaris perfusion density compared with control.…”

Section: Discussionmentioning

confidence: 89%

Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

et al. 2018

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Section: Discussionmentioning

confidence: 89%

Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

et al. 2018

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“…The decrease of CT in DM patients can be confirmed by the atrophy and extensive loss of choroidal capillaries in DM eyes, observed in histological studies [5][6][7], as well as the decrease of choroidal blood flow in DM patients observed in hemodynamic studies [9,31,32]. Further analysis of en-face OCT and other OCT image data has shown that decreased choroidal vascular density (CVD), vascular area, choroidal vascular volume, and overall choroidal volume (CV) were correlated with decreased CT [17,33].…”

Section: Discussionmentioning

confidence: 82%

Thinner Average Choroidal Thickness Is a Risk Factor for the Onset of Diabetic Retinopathy

et al. 2020

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Purpose: To analyze the relationships between choroidal thickness (CT) and diabetes mellitus (DM), diabetic retinopathy (DR), and DR severity in community residents diagnosed with type 2 DM, and to explore whether CT can improve the discriminatory ability of other risk factors to predict the incidence of DR. Methods: A total of 1,250 type 2 DM residents and 1,027 healthy controls in Xinjing community of Shanghai participated a cross-sectional survey of eye diseases in 2016. CT was measured using swept-source optical coherence tomography. DR was classified according to the 2002 international clinical classification of DR. A total of 537 subjects with type 2 DM without DR at the 2016 survey were followed up in 2018 to investigate the 2-year incidence of DR. Receiver operating characteristic curve analysis was used to test the accuracy of different indicators in predicting the onset of DR. Results: The central CT of the control, no DR, mild non-proliferative DR (NPDR), moderate NPDR, severe NPDR, and PDR groups were 223. 40, 216.22, 213.57, 211.91, 178.47, and 168.15 μm, respectively (p for trend < 0.001), and the average CT (ACT) were 197. 83, 186.94, 182.03, 178.00, 156.91, and 136.72 μm respectively (p for trend < 0.001). Body mass index (BMI), DM duration, fasting blood glucose, glycosylated hemoglobin (HbA1C), and ACT were risk factors for 2-year DR incidence. For the onset of DR, as predicted by ACT, after tenfold cross validation the average area under the curve was 0.55 (p = 0.048). Addition of ACT did not improve the discriminatory ability of DM duration, BMI, glucose and HbA1C on the incidence of DR (Z = 0.48; p = 0.63). Conclusions: As the severity of DR increased, the CT of community type 2 DM patients showed a significant downward trend compared with the healthy controls. Thinner ACT was found to be a risk factor for DR incidence, but it did not improve the discriminatory ability of other risk factors to predict the incidence of DR.

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“…Therefore, in general, the CT showed an increase in value; nevertheless, early DC may have occurred at temporal of the macula because of the decreased level of CT. At the anatomical level, it is likely that compared with the optic disc area, the vascular density of the macula may become sparser based on the longer distance between the temporal of the macula and the Zinn vascular ring. Wang et al (2017) observed that under hyperglycemic condition, the inner ring at the temporal of PMCT was more sensitive to hypoxia and the vascular density decreased significantly. Esmaeelpour et al (2012) also reported that the temporal of PMCT showed more significant decrease in vascular density than other regions of the macula in elderly patients with T1DM with DR and speculated that it may be related to the type of diabetes and characteristic of this area to be prone to oedema and hyperplasia.…”

Section: The Change Trend Of Ct At the Posterior Pole In Children Witmentioning

confidence: 89%

“…Wang et al. () observed that under hyperglycemic condition, the inner ring at the temporal of PMCT was more sensitive to hypoxia and the vascular density decreased significantly. Esmaeelpour et al.…”

Section: Discussionmentioning

confidence: 99%

“…Since the optic fissure located below the optic disc was reported as the last place to close during evolution of the eyeball, histologically, the CT was relatively low (Huang et al 2013). A choroidal vessel watershed zone was also located in the area, which was the boundary of the blood supply terminal of two or more short posterior ciliary arteries; consequently, there were fewer choroid capillaries, resulting in lower thickness (Zhu & Wallman 2009;Wang et al 2017). In case of hyperglycemia and relative hypoxia in the diabetic choroid, hemangiectasis and oedema could be more advanced as compared to the other areas, resulting in increased CT.…”

Section: The Characteristic Sectors Of Posterior Pole Ct Of Children mentioning

confidence: 99%

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Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy

Jia

Wang

et al. 2019

Acta Ophthalmologica

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Purpose To study the characteristics of choroid thickness (CT) of the optic disc and macula in children with type 1 diabetes mellitus (T1DM) without visual impairment and diabetic retinopathy (DR) and analyse associated factors. Methods A square area of 6 × 6 mm around the centre of the optic disc and macula was scanned. The indices analysed mainly included CT at the macular centre (1 mm), and temporal, superior, nasal or inferior aspect of the inner ring (1–3 mm) and outer ring of (3–6 mm) optic disc and macula. Independent risk factors were analysed using multifactor linear regression. Results A total of 44 children with T1DM and 48 healthy subjects were enrolled. The diabetic group showed significant increase in the inferior inner ring of parapapillary CT (100.99 ± 30.42 μm versus 89.41 ± 34.00 μm, p = 0.04) and nasal outer ring of parapapillary CT (157.02 ± 47.35 μm versus 131.15 ± 35.17 μm, p = 0.01) as compared to those values in the healthy controls. Spherical equivalent refraction and family history of hypertension are independent factors of both peripappillary choroid thickness (PPCT) and macular choroid thickness (PMCT). Spherical equivalent refraction (p = 0.01) and serum cholesterol (p = 0.03) were independent factors of the inferior inner ring of parapapillary CT, whereas family history of hypertension was an independent factor of the nasal outer ring of parapapillary CT (p = 0.001). Conclusion In children with diabetes without DR or visual impairment, the CT increase in nasal outer ring of parapapillary (PPNO) and the inferior inner ring of parapapillary (PPII) may be the characteristic pre‐DR alteration at the early stage of DM. For children with higher serum cholesterol and family history of hypertension, the change of the nasal outer ring of parapapillary CT and the inferior inner ring of parapapillary CT may be more advanced.

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Diabetic Choroidopathy: Choroidal Vascular Density and Volume in Diabetic Retinopathy With Swept-Source Optical Coherence Tomography

Abstract: Choroidal vascular density and volume are significantly reduced in more advanced stages of diabetic retinopathy. New imaging modalities should allow further exploration of the contributions of choroidal vessel disease to diabetic eye disease pathogenesis, prognosis, and treatment response.

Cited by 72 publications

References 42 publications

Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

Choriocapillaris and retinal vascular plexus density of diabetic eyes using split-spectrum amplitude decorrelation spectral-domain optical coherence tomography angiography

Thinner Average Choroidal Thickness Is a Risk Factor for the Onset of Diabetic Retinopathy

Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy

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