Effects of Systemic Profiles on Choroidal Thickness in Treatment-Naïve Eyes With Diabetic Retinopathy

Abstract

Purpose The purpose of this study was to analyze the effects of systemic and ocular profiles on subfoveal choroidal thickness (SFChT) in treatment-naïve eyes with diabetic retinopathy (DR). Methods This study included patients with treatment-naïve DR. They underwent routine laboratory evaluations, including complete blood cell count, liver function tests, kidney function tests, and urinalysis for macroalbuminuria. The systemic and ocular factors associated with the change in SFChT in DR were analyzed. Results A total of 136 eyes from 136 patients with diabetes and 30 eyes from 30 age-matched healthy controls were recruited. Generalized linear model analyses showed that the SFChT in treatment-naïve eyes with DR was positively associated with the DR grade and estimated glomerular filtration rate (eGFR; P = 0.001) and negatively associated with age ( P < 0.001) and serum phosphorus levels ( P = 0.001). Treatment-naïve eyes with proliferative DR (PDR; 313.4 ± 9.0 µm) or severe nonproliferative DR (NPDR; 299.7 ± 9.7 µm) had thicker choroid than eyes with mild to moderate NPDR (251.7 ± 11.1 µm) or no DR (231.2 ± 14.5 µm) after adjusting for age, eGFR, and phosphorus levels. Conclusions Choroid is affected by renal function and the grade of DR in patients with diabetes. Advanced retinopathy is associated with choroidal thickening, and the severity of concomitant renal disease is associated with choroidal thinning.

The Relationship Between Retinal and Choroidal Thickness and Adiponectin Concentrations in Patients With Type 2 Diabetes Mellitus

“…DR severity has been positively related to retinal and choroidal thickness. 10 , 11 , 43 VEGF is a growth factor responsible for this relationship. 10 , 44 In addition, anti-VEGF treatment reduced choroidal thickness.…”

Longitudinal Analysis of Diabetic Choroidopathy in Proliferative Diabetic Retinopathy Treated With Panretinal Photocoagulation Using Widefield Swept-Source Optical Coherence Tomography

“…[7][8][9][10] However, one, recent, large, well-controlled study found that subfoveal CT increases with DR severity. 11 By 1 month after PRP, multiple groups have found that the subfoveal choroid irreversibly thins [12][13][14][15][16][17] and subfoveal choroidal blood flow decreases, 13,14 but despite thinning of the subfoveal choroid, there are no changes in the subfoveal CVI after PRP. 17 Baseline values for MCT measurements were averaged for each of the five regions described in the Methods.…”

“…[3][4][5] This decrease in diabetic choroidal vascularity is consistent with in vivo measurements of decreased subfoveal choroidal blood flow in patients with diabetes. 6 Studies using subfoveal optical coherence tomography (OCT) to measure whether choroidal thickness (CT) varies with the stage of DR have reported conflicting results, [7][8][9][10][11] but a consistent finding is that the subfoveal mean CT (MCT) decreases after panretinal photocoagulation (PRP) for proliferative DR (PDR). [12][13][14][15][16][17] Moreover, subfoveal choroidal blood flow, measured in vivo using laser speckle flowgraphy (LSF), reliably decreases after PRP.…”

Correlation of Renal Profiles with Choroidal Vascularity Index in Eyes with Diabetic Retinopathy

“…Previously, we investigated the correlation between SFChT and systemic profiles [ 21 , 22 , 46 ]. These studies suggested a correlation between choroid and CKD.…”

“…Clinically, this causes various systemic complications, including cardiovascular disease, chronic kidney disease (CKD), and chorioretinopathy [ 18 , 19 , 20 ]. Recently, we investigated the correlation between subfoveal choroidal thickness (SFChT) and CKD in patients with DR [ 21 , 22 ]. However, CVI is known to be less variable [ 23 ].…”