Abstract
Aims This study aimed to compare the accuracy of the choroidal vascularity index (CVI) and diabetic retinopathy (DR) in the diagnosis of diabetic nephropathy (DN). Methods We performed a cross-sectional study of 117 patients with proteinuria and diabetes mellitus (DM) in which 45 patients were diagnosed with DN by renal pathology. Demographic information, clinical features, and laboratory data were collected. A total of 234 eyes underwent evaluation of DR and the CVI using enhanced depth imaging-optical coherence tomography scans. We analyzed the association between the CVI and DN and compared the CVI and DR for diagnosing DN using area under receiver operating characteristic curves (AUROCs). Results The severe nonproliferative DR and proliferative DR groups showed a lower CVI than the no DR and mild/moderate nonproliferative DR groups (P < 0.01 or P < 0.001). There was a significantly lower CVI in patients with DN stage III (63.01% ± 1.47%) compared with those in DN stages IIa (62.1% ± 1.41%, P < 0.001) and IIb (59.85% ± 1.98%, P < 0.01). The sensitivity and specificity of the CVI for diagnosing DN were 84% (71%–94%) and 95% (88%–99%), respectively, which were preferable to those of DR. The AUROCs for the CVI and DR for diagnosing DN were 0.932 and 0.831, respectively. The CVI outperformed DR for diagnosing DN (P < 0.05). The cutoff value of the CVI was 63.13%. Conclusion The CVI might be a reliable noninvasive technique for predicting the pathological stage of DN and is superior to DR in diagnosing DN.
Highlights
Recent studies have suggested that the prevalence of diabetes mellitus (DM) is approximately 11% of the population worldwide, and DM affects 138 million adults in China [1, 2]
Morphological abnormalities of the choroid may represent a systemic microvascular injury, and choroidal thickness has been reported to be associated with renal hemodynamics in essential hypertension [8]. e choroidal vascularity index (CVI) is defined as the ratio of the luminal area (LA) to the total choroidal area (TCA). e CVI is a novel tool for assessing the vascular network of the choroid using enhanced depth imaging-optical coherence tomography (EDI-OCT) scans [9–11]. e CVI is considered as a more stable and less variable parameter for estimating Journal of Ophthalmology abnormalities in the choroidal vasculature than choroidal thickness [10]
Sensitivity and specificity were calculated. e optimal cutoff value for the CVI was obtained using the criterion of maximal sum of sensitivity and specificity
Summary
Recent studies have suggested that the prevalence of diabetes mellitus (DM) is approximately 11% of the population worldwide, and DM affects 138 million adults in China [1, 2]. E renal and ocular microcirculations are analogous because the kidneys and eyes have similar physiological and pathological pathways. Erefore, the eyes are an accessible “window” through which we can speculate renal diseases including DN [4, 5]. E choroid is the highly vascularized structure in the eye, from which the retina receives its blood supply [7]. Morphological abnormalities of the choroid may represent a systemic microvascular injury, and choroidal thickness has been reported to be associated with renal hemodynamics in essential hypertension [8]. E choroidal vascularity index (CVI) is defined as the ratio of the luminal area (LA) to the total choroidal area (TCA). E CVI is a novel tool for assessing the vascular network of the choroid using enhanced depth imaging-optical coherence tomography (EDI-OCT) scans [9–11]. Morphological abnormalities of the choroid may represent a systemic microvascular injury, and choroidal thickness has been reported to be associated with renal hemodynamics in essential hypertension [8]. e choroidal vascularity index (CVI) is defined as the ratio of the luminal area (LA) to the total choroidal area (TCA). e CVI is a novel tool for assessing the vascular network of the choroid using enhanced depth imaging-optical coherence tomography (EDI-OCT) scans [9–11]. e CVI is considered as a more stable and less variable parameter for estimating
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