Abstract
BackgroundTo represent choroidal thickness (CT) and choroidal volume (CV) databases in diabetic retinopathy (DR) patients and healthy control participants using optical coherence tomography (OCT) and enhanced depth imaging OCT (EDI-OCT). No study had evaluated CT at all main stages of diabetic retinopathy in a single study.MethodsThe study included 176 eyes from 93 patients (39–80 years old; 42% females) who were divided into three groups based on DR severity and normal control group: 39 eyes no DR, 64 eyes NPDR, 33 eyes PDR, and 40 eyes normal control. The CT and CV were measured and statistically analyzed. Intra-observer and inter-observer coefficients of repeatability were calculated.ResultsSubfoveal CT showed persistent thinning from normal group (322.50 ± 69.24) to no-diabetic retinopathy (NDR, 308.33 ± 74.45) to nonproliferative diabetic retinopathy (NPDR, 283.45 ± 56.50) group and then thickening as the patient progressed to proliferative diabetic retinopathy (PDR, 295.17 ± 95.69) (P = 0.087). A significant difference was found between the control group and the NDR, NPDR, and PDR groups in nearly all CT and CV of Early Treatment Diabetic Retinopathy Study macular subfields. Fasting blood sugar (FBS = 189.08 ± 51.3 mg/dl) and diabetes mellitus (DM) duration (13.6 ± 6.5 years) had no noticeable effect on CT. In patients with diabetes, the best-corrected visual acuity (BCVA), diabetic macular edema (DME), and foveal avascular zone (FAZ) were not affected by CT and CV.ConclusionsThe choroidal thickness decreases from the early stages of diabetic retinopathy up to the NPDR stage, with a subsequent modest rise in CT during the PDR stage. There was no correlation between FBS, diabetes duration, BCVA, DME, and FAZ, and CT.
Highlights
To represent choroidal thickness (CT) and choroidal volume (CV) databases in diabetic retinopathy (DR) patients and healthy control participants using optical coherence tomography (OCT) and enhanced depth imaging OCT (EDI-OCT)
Based on the DR severity scale, the group with diabetes were classified as 39 eyes with no diabetic retinopathy (NDR), 64 eyes with nonproliferative diabetic retinopathy (NPDR) (40 eyes with mild to moderate NPDR and 24 eyes with severe NPDR), and 33 eyes with proliferative diabetic retinopathy (PDR) (20 early PDR and 13 eyes with high-risk characteristic PDR including preretinal and vitreous hemorrhage) and compared with 40 normal participants’ eye
We found that CT increased in the transition from NPDR to PDR, given the declining trend in the preceding stages
Summary
To represent choroidal thickness (CT) and choroidal volume (CV) databases in diabetic retinopathy (DR) patients and healthy control participants using optical coherence tomography (OCT) and enhanced depth imaging OCT (EDI-OCT). No study had evaluated CT at all main stages of diabetic retinopathy in a single study. Diabetes is a metabolic disease affecting the vascular system. While the main changes in diabetic eyes occur in the retinal vasculature, some changes have been detected in the choroidal layer, which supplies the outer retina [1,2,3]. Considering that the choroid is the most vascularized and metabolically active tissue in the eye, its pathologic and clinical involvement may be expected in diabetes [3]. Several studies have indicated that the choroid is a key participant in the pathogenesis of diabetic retinopathy (DR) and diabetic macular edema (DME) due to changes in the blood retinal barrier (BRB) [1, 2]. Histologic studies showed that the choroid of persons with DME often displays increased vessel tortuosity, with microaneurysm and narrowing, hyper-cellularity, vascular loops, microaneurysms; choriocapillaris (CC) drop-out, neovascularization, and sinuslike configurations between choroidal lobules [1, 4,5,6]
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