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Choroidal thickness changes in non-treated eyes of patients with diabetes: swept-source optical coherence tomography study

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Abstract

Aims

To measure choroidal thickness (CT) in diabetic eyes and its correlation with metabolic status and the severity of diabetic retinopathy (DR).

Materials and methods

Prospective cross-sectional study using swept-source optical coherence tomography. CT maps of 96 treatment naïve eyes of 48 patients with diabetes were compared to 46 eyes of 23 healthy controls. CT changes and their relation to diabetes, age, gender, disease duration, hypertension (HT), hemoglobin A1c level, type and severity of DR were evaluated.

Results

A significantly thinner choroid was measured in patients with diabetes compared to controls (p < 0.009). In the diabetic group age, gender, disease duration and HT were significantly correlated with CT in univariable regression models (p < 0.05). In multivariable analysis, the duration of diabetes significantly negatively correlated with CT (p = 0.02). According to analysis of variance, there was a significant difference among means of CT in different stages of DR (p = 0.002), with thinner CT in cases with more advanced DR. In a multivariable predictive model, thinner CT was associated with an increased risk for the presence of DR (p = 0.02).

Conclusions

Diabetes mellitus itself and the severity of DR affect CT significantly, even after adjusting for the effects of confounding systemic factors. Disease duration seems to be associated with a reduction of choroidal thickness. Decreased CT proved to be correlated with the severity of DR.

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References

  1. Tóth G, Szabó D, Sándor GL et al (2017) Diabetes and diabetic retinopathy in people aged 50 years and older in Hungary. Br J Ophthalmol 101:965–969

    Article  PubMed  Google Scholar 

  2. Antonetti DA, Klein R, Gardner TW (2012) Diabetic retinopathy. N Engl J Med 366:1227–1239

    Article  PubMed  CAS  Google Scholar 

  3. Antonetti DA, Lieth E, Barber AJ, Gardner TW (1999) Molecular mechanisms of vascular permeability in diabetic retinopathy. Semin Ophthalmol 14:240–248

    Article  PubMed  CAS  Google Scholar 

  4. Nickla DL, Wallman J (2010) The multifunctional choroid. Prog Retin Eye Res 29:144–168

    Article  PubMed  Google Scholar 

  5. Cao J, McLeod S, Merges CA, Lutty GA (1998) Choriocapillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol 116:589–597

    Article  PubMed  CAS  Google Scholar 

  6. Shiragami C, Shiraga F, Matsuo T, Tsuchida Y, Ohtsuki H (2002) Risk factors for diabetic choroidopathy in patients with diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 240:436–442

    Article  PubMed  Google Scholar 

  7. Freeman WR, Bartsch DU, Mueller AJ, Banker AS, Weinreb RN (1998) Simultaneous indocyanine green and fluorescein angiography using a confocal scanning laser ophthalmoscope. Arch Ophthalmol 116:455–463

    Article  PubMed  CAS  Google Scholar 

  8. Laviers H, Zambarakji H (2014) Enhanced depth imaging-OCT of the choroid: a review of the current literature. Graefes Arch Clin Exp Ophthalmol 252:1871–1883

    Article  PubMed  CAS  Google Scholar 

  9. Ruiz-Medrano J, Flores-Moreno I, Pena-Garcia P, Montero JA, Duker JS, Ruiz-Moreno JM (2014) Macular choroidal thickness profile in a healthy population measured by swept-source optical coherence tomography. Investig Ophthalmol Vis Sci 55:3532–3542

    Article  Google Scholar 

  10. Copete S, Flores-Moreno I, Montero JA, Duker JS, Ruiz-Moreno JM (2014) Direct comparison of spectral-domain and swept-source OCT in the measurement of choroidal thickness in normal eyes. Br J Ophthalmol 98:334–338

    Article  PubMed  Google Scholar 

  11. Zafar S, Siddiqui MA, Shahzad R (2016) Comparison of choroidal thickness measurements between spectral-domain OCT and swept-source OCT in normal and diseased eyes. Clin Ophthalmol 14:10:2271–2276

    Article  Google Scholar 

  12. Kim JT, Lee DH, Joe SG, Kim JG, Yoon YH (2013) Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Investig Ophthalmol Vis Sci 54:3378–3384

    Article  Google Scholar 

  13. Regatieri CV, Branchini L, Carmody J, Fujimoto JG, Duker JS (2012) Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina 32:563–568

    Article  PubMed  PubMed Central  Google Scholar 

  14. Querques G, Lattanzio R, Querques L et al (2012) Enhanced depth imaging optical coherence tomography in type 2 diabetes. Investig Ophthalmol Vis Sci 53:6017–6024

    Article  Google Scholar 

  15. Vujosevic S, Martini F, Cavarzeran F, Pilotto E, Midena E (2012) Macular and peripapillary choroidal thickness in diabetic patients. Retina 32:1781–1790

    Article  PubMed  Google Scholar 

  16. Esmaeelpour M, Povazay B, Hermann B et al (2011) Mapping choroidal and retinal thickness variation in type 2 diabetes using three-dimensional 1060-nm optical coherence tomography. Investig Ophthalmol Vis Sci 52:5311–5316

    Article  Google Scholar 

  17. Campos A, Campos EJ, Martins J, Ambrósio AF, Silva R (2017) Viewing the choroid: where we stand, challenges and contradictions in diabetic retinopathy and diabetic macular oedema. Acta Ophthalmol 95:446–459

    Article  PubMed  Google Scholar 

  18. Melancia D, Vicente A, Cunha JP, Abegão Pinto L, Ferreira J (2016) Diabetic choroidopathy: a review of the current literature. Graefes Arch Clin Exp Ophthalmol 254:1453–1461

    Article  PubMed  Google Scholar 

  19. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 20:1183

    Article  Google Scholar 

  20. Early Treatment Diabetic Retinopathy Study Research Group (1991) Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie House classification: ETDRS report number 10. Ophthalmology 98:786–806

    Article  Google Scholar 

  21. Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127:688–693

    Article  PubMed  CAS  Google Scholar 

  22. Early Treatment Diabetic Retinopathy Study Research Group (1991) Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Ophthalmology 98:807–822

    Article  Google Scholar 

  23. Shin YU, Lee MJ, Lee BR (2015) Choroidal maps in different types of macular edema in branch retinal vein occlusion using swept-source optical coherence tomography. Am J Ophthalmol 160:328–334

    Article  PubMed  Google Scholar 

  24. Min JK, Lee S, Kim JS, Woo JM, Yang HS (2017) Effects of diabetic macular edema on repeatability of retinal nerve fiber layer thickness measurements at the macular and peripapillary area using swept-source optical coherence tomography. Curr Eye Res 42:307–314

    Article  PubMed  Google Scholar 

  25. Wang J, Gao X, Huang W et al (2015) Swept-source optical coherence tomography imaging of macular retinal and choroidal structures in healthy eyes. BMC Ophthalmol 15:122

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Han YS, Lim HB, Lee SH, Kim JY (2015) Diurnal variation in choroidal and retinal thickness of the early treatment of diabetic retinopathy study macular subfields determined using swept-source optical coherence tomography. Ophthalmologica 233:192–197

    Article  PubMed  Google Scholar 

  27. Bafiq R, Mathew R, Pearce E et al (2015) Age, sex, and ethnic variations in inner and outer retinal and choroidal thickness on spectral-domain optical coherence tomography. Am J Ophthalmol 160:1034–1043

    Article  PubMed  Google Scholar 

  28. Akay F, Gundogan FC, Yolcu U, Toyran S, Uzun S (2016) Choroidal thickness in systemic arterial hypertension. Eur J Ophthalmol 26:152–157

    Article  PubMed  Google Scholar 

  29. Abadia B, Suñen I, Calvo P, Bartol F, Verdes G, Ferreras A (2018) Choroidal thickness measured using swept-source optical coherence tomography is reduced in patients with type 2 diabetes. PLoS One 13(2):e0191977

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Ünsal E, Eltutar K, Zirtiloğlu S, Dinçer N, Ozdoğan Erkul S, Güngel H (2014) Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol 8:637–642

    Article  PubMed  PubMed Central  Google Scholar 

  31. Giuffrè G, Lodato G, Dardanoni G (2004) Prevalence and risk factors of diabetic retinopathy in adult and elderly subjects: the Casteldaccia Eye Study. Graefe’s Arch Clin Exp Ophthalmol 242:535–540

    Article  Google Scholar 

  32. Lee HK, Lim JW, Shin MC (2013) Comparison of choroidal thickness in patients with diabetes by spectral-domain optical coherence tomography. Korean J Ophthalmol 27:433–439

    Article  PubMed  PubMed Central  Google Scholar 

  33. Laíns I, Talcott KE, Santos AR et al (2018) Choroidal thickness in diabetic retinopathy assessed with Swept-Source optical coherence tomography. Retina 38:173–182

    Article  PubMed  Google Scholar 

  34. de Freytas A, Gallego Pinazo R, Cisneros Lanuza Á (2016) Subfoveal choroidal thickness in eyes with diabetic macular oedema using swept source optical coherence tomography. Arch Soc Esp Oftalmol 91:228–231

    Article  PubMed  Google Scholar 

  35. Tan CS, Cheong KX, Lim LW, Sadda SR (2016) Comparison of macular choroidal thicknesses from swept source and spectral domain optical coherence tomography. Br J Ophthalmol 100:995–999

    Article  PubMed  Google Scholar 

  36. Matsuo Y, Sakamoto T, Yamashita T, Tomita M, Shirasawa M, Terasaki H (2013) Comparisons of choroidal thickness of normal eyes obtained by two different spectral-domain OCT instruments and one swept-source OCT instrument. Investig Ophthalmol Vis Sci 54:7630–7636

    Article  Google Scholar 

  37. Zhang Z, Meng X, Wu Z, Zou W, Zhang J, Zhu D (2015) Changes in choroidal thickness after panretinal photocoagulation for diabetic retinopathy: a 12-week longitudinal study. Investig Ophthalmol Vis Sci 56:2631–2638

    Article  Google Scholar 

  38. Laíns I, Figueira J, Santos AR et al (2014) Choroidal thickness in diabetic retinopathy: the influence of antiangiogenic therapy. Retina 34:1199–1207

    Article  PubMed  CAS  Google Scholar 

  39. Schocket LS, Brucker AJ, Niknam RM, Grunwald JE, DuPont J, Brucker AJ (2004) Foveolar choroidal hemodynamics in proliferative diabetic retinopathy. Int Ophthalmol 25:89–94

    Article  PubMed  Google Scholar 

  40. Lutty GA, McLeod DS (2005) Phosphatase enzyme histochemistry for studying vascular hierarchy, pathology, and endothelial cell dysfunction in retina and choroid. Vis Res 45:3504–3511

    Article  PubMed  CAS  Google Scholar 

  41. Lutty GA (2017) Diabetic choroidopathy. Vis Res 139:161–167

    Article  PubMed  Google Scholar 

  42. Nagaoka T, Kitaya N, Sugawara R et al (2004) Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes. Br J Ophthalmol 88:1060–1063

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  43. Murakami T, Uji A, Suzuma K et al (2016) In vivo choroidal vascular lesions in diabetes on swept-source optical coherence tomography. PLoS One 11(8):e0160317

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  44. Agemy SA, Scripsema NK, Shah CM et al (2015) Retinal vascular perfusion density mapping using optical coherence tomography angiography in normals and diabetic retinopathy patients. Retina 35:2353–2363

    Article  PubMed  Google Scholar 

  45. Abbey AM, Kuriyan AE, Modi YS et al (2015) Optical coherence tomography measurements of choroidal thickness in healthy eyes: correlation with age and axial length. Ophthalmic Surg Lasers Imaging Retina 46:18–24

    Article  PubMed  Google Scholar 

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Correspondence to Hajnalka Horváth.

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Statement of human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Written informed consent was obtained before the examination from each patient, as well as the approval from our institutional ethics committee.

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None of the authors have any financial/conflicting interests to disclose.

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Managed by Massimo Porta.

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Horváth, H., Kovács, I., Sándor, G.L. et al. Choroidal thickness changes in non-treated eyes of patients with diabetes: swept-source optical coherence tomography study. Acta Diabetol 55, 927–934 (2018). https://doi.org/10.1007/s00592-018-1169-0

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  • DOI: https://doi.org/10.1007/s00592-018-1169-0

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