Abstract
ObjectiveTo compare choroidal thickness between patients with type 2 diabetes (T2D) and healthy controls measured using swept-source optical coherence tomography (SS-OCT).MethodsThe sample comprised 157 eyes of 94 T2D patients, 48 eyes of which had diabetic macular edema (DME), and 71 normal eyes of 38 healthy patients. Subfoveal (SF) choroidal thickness, and choroidal thickness at 500-μm intervals up to 2500 μm nasal and temporal from the fovea were measured using the SS-OCT. Choroidal thicknesses were compared between groups using Student’s t-test. Additionally, Pearson correlations were calculated between diabetes duration, glycosylated hemoglobin (HbA1c) levels, and choroidal thickness.ResultsMean diabetes duration was 16.6±9.5 years, while mean glycosylated hemoglobin was 7.7±1.3%. Overall, the choroid was significantly thinner in T2D patients. Individuals with DME had reduced choroidal thickness in all measurements, except at 2000 and 2500-μm nasal positions, compared to healthy controls. There was a moderate correlation between choroidal thickness and HbA1c levels in DME patients (SF: r = 0.342; p = 0.017). Diabetes duration did not correlate significantly with choroidal thickness.ConclusionSS-OCT measurements revealed that the choroid was significantly thinner in T2D patients, moderate non-proliferative diabetic retinopathy patients, and DME patients than in healthy individuals. Further studies are needed to clarify the effect of diabetes on this layer and the relationship between choroidal thickness and DME.
Highlights
Diabetes mellitus (DM) is chronic disease affecting 415 million people worldwide, and the prevalence is expected to rise to an estimated 642 million by the year 2040 [1]
The choroid was significantly thinner in type 2 diabetes (T2D) patients
There was a moderate correlation between choroidal thickness and HbA1c levels in diabetic macular edema (DME) patients (SF: r = 0.342; p = 0.017)
Summary
Diabetes mellitus (DM) is chronic disease affecting 415 million people worldwide, and the prevalence is expected to rise to an estimated 642 million by the year 2040 [1]. The choroidal layer supplies blood to the outer layers of the retina and may play a key role in the pathophysiologic mechanism of diabetic retinopathy (DR). The most consequential changes of the choroid mainly affect the choriocapillaris layer, but may extend to larger vessels located in the outer choroidal layers [2,3]. The choroid seems to play a role in different retinal pathologies [4]. Recent studies regarding neovascular age-related macular degeneration and diabetes reported that choroidal thickness may predict the response to antiangiogenic agents [5,6]. The assessment of choroidal changes may help to better make therapeutic decisions and to improve treatment follow-up
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