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Choroidal vascularity index as a predictor for the development of retinopathy in diabetic patients

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Abstract

Background

Today, limited and controversial data are available on predictive markers for diabetic retinopathy. Choroidal thickness (CT) is an unstable parameter affected by many factors. Also, previous studies had conflicting findings on choroidal thickness. In this study, we aimed to investigate the role of choroidal vascularity index (CVI), a relatively new marker, in evaluating choroidal vascular status and its relationship with diabetic retinopathy (DR).

Materials and methods

A total of 124 subjects, 84 patients with type 2 diabetes mellitus (DM) and 40 healthy controls, were included in the study. The patients were divided into two groups as follows: those without DR and those with non-proliferative DR (NPDRP). All subjects underwent enhanced-depth imaging optical coherence tomography (EDI-OCT), and CT values were noted. To measure CVI, luminal (LA) and stromal areas of the choroidal images were binarized using Image J program. CVI was defined as the proportion of LA to total choroid area (TCA). Demographic and laboratory data of the patients were collected retrospectively.

Results

CVI were found to be lower in diabetic patients compared to non-diabetic patients. CVI values in 3 groups were as follows: 67.9% ± 1.8 (healthy controls), 66.1% ± 2.4 (no DR), and 63.2% ± 2.6 (NPDRP) (p < 0.001). All groups were similar in terms of CT values (p = 0.296). The cut-off value for CVI in predicting retinopathy was 64.7%. Hypertension and current smoking were found to be more frequent in diabetic patients with CVI < 64.7% compared to those with CVI > 64.7%.

Conclusions

CVI tends to be lower in diabetic patients with or without DR compared to healthy controls. Moreover, patients with DR have a lower CVI than those without DR. CVI can be considered an early and sensitive biomarker for the onset of DR.

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References

  1. Zoungas S, Woodward M, Li Q, Cooper ME, Hamet P, Harrap S et al (2014) Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes. Diabetologia 57(12):2465–2474

    Article  PubMed  Google Scholar 

  2. Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414(6865):782–787

    Article  CAS  PubMed  Google Scholar 

  3. Klein BE (2007) Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol 14(4):179–183

    Article  PubMed  Google Scholar 

  4. Venturini M, Fiorina P, Maffi P, Losio C, Vergani A, Secchi A et al (2006) Early increase of retinal arterial and venous blood flow velocities at color Doppler imaging in brittle type 1 diabetes after islet transplant alone. Transplantation 81(9):1274–1277

    Article  PubMed  Google Scholar 

  5. Lovasik JV, Kergoat H (1993) Electroretinographic results and ocular vascular perfusion in type 1 diabetes. Investig Ophthalmol Vis Sci 34(5):1731–1743

    CAS  Google Scholar 

  6. Holopigian K, Greenstein VC, Seiple W, Hood DC, Carr RE (1997) Evidence for photoreceptor changes in patients with diabetic retinopathy. Investig Ophthalmol Vis Sci 38(11):2355–2365

    CAS  Google Scholar 

  7. 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(3):563–568

    Article  PubMed  PubMed Central  Google Scholar 

  8. Esmaeelpour M, Povazay B, Hermann B, Hofer B, Kajic V, Kapoor K et al (2010) Three-dimensional 1060-nm OCT: choroidal thickness maps in normal subjects and improved posterior segment visualization in cataract patients. Investig Ophthalmol Vis Sci 51(10):5260–5266

    Article  Google Scholar 

  9. Vujosevic S, Martini F, Cavarzeran F, Pilotto E, Midena E (2012) Macular and peripapillary choroidal thickness in diabetic patients. Retina 32(9):1781–1790

    Article  PubMed  Google Scholar 

  10. Xu J, Xu L, Du KF, Shao L, Chen CX, Zhou JQ et al (2013) Subfoveal choroidal thickness in diabetes and diabetic retinopathy. Ophthalmology 120(10):2023–2028

    Article  PubMed  Google Scholar 

  11. Iovino C, Pellegrini M, Bernabei F, Borrelli E, Sacconi R, Govetto A et al (2020) Choroidal vascularity index: an in-depth analysis of this novel optical coherence tomography parameter. J Clin Med 9(2)

  12. Goud A, Singh SR, Sahoo NK, Rasheed MA, Vupparaboina KK, Ankireddy S et al (2019) New insights on choroidal vascularity: a comprehensive topographic approach. Investig Ophthalmol Vis Sci 60(10):3563–3569

    Article  Google Scholar 

  13. Hidayat AA, Fine BS (1985) Diabetic choroidopathy. Light and electron microscopic observations of seven cases. Ophthalmology 92(4):512–522

    Article  CAS  PubMed  Google Scholar 

  14. 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(6):436–442

    Article  PubMed  Google Scholar 

  15. Hamadneh T, Aftab S, Sherali N, Vetrivel Suresh R, Tsouklidis N, An M (2020) Choroidal changes in diabetic patients with different stages of diabetic retinopathy. Cureus 12(10):e10871

    PubMed  PubMed Central  Google Scholar 

  16. Wang H, Tao Y (2019) Choroidal structural changes correlate with severity of diabetic retinopathy in diabetes mellitus. BMC Ophthalmol 19(1):186

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kim M, Ha MJ, Choi SY, Park YH (2018) Choroidal vascularity index in type-2 diabetes analyzed by swept-source optical coherence tomography. Sci Rep 8(1):70

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tan KA, Laude A, Yip V, Loo E, Wong EP, Agrawal R (2016) Choroidal vascularity index - a novel optical coherence tomography parameter for disease monitoring in diabetes mellitus? Acta Ophthalmol 94(7):e612–e616

    Article  PubMed  Google Scholar 

  19. Sudhalkar A, Chhablani JK, Venkata A, Raman R, Rao PS, Jonnadula GB (2015) Choroidal thickness in diabetic patients of Indian ethnicity. Indian J Ophthalmol 63(12):912–916

    Article  PubMed  PubMed Central  Google Scholar 

  20. Unsal E, Eltutar K, Zirtiloglu S, Dincer N, OzdoganErkul S, Gungel H (2014) Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol 8:637–642

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rewbury R, Want A, Varughese R, Chong V (2016) Subfoveal choroidal thickness in patients with diabetic retinopathy and diabetic macular oedema. Eye (London) 30(12):1568–1572

    Article  CAS  Google Scholar 

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolic Diseases, Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Bolu, Turkey

    Ç. Keskin & E. N. A. Dilekçi

  2. Department of Ophthalmology, Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Bolu, Turkey

    A. Y. Üçgül, R. K. Üçgül & G. Toprak

  3. Department of Internal Medicine, Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Bolu, Turkey

    D. Cengiz

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  1. Ç. Keskin
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  2. E. N. A. Dilekçi
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  3. A. Y. Üçgül
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  4. R. K. Üçgül
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  5. G. Toprak
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Correspondence to Ç. Keskin.

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Keskin, Ç., Dilekçi, E.N.A., Üçgül, A.Y. et al. Choroidal vascularity index as a predictor for the development of retinopathy in diabetic patients. J Endocrinol Invest 47, 1175–1180 (2024). https://doi.org/10.1007/s40618-023-02236-8

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  • DOI: https://doi.org/10.1007/s40618-023-02236-8

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