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Functional correlation between choroidal and retinal vascularity in low-grade diabetic retinopathy

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Abstract

Aims

To perform an automated functional assessment of retinal and choroidal microvasculature in eyes with low-grade diabetic retinopathy (DR) using optical coherence tomography angiography (OCT-A) and to identify potential perfusion changes in case of early vascular damage.

Methods

This is an observational, case–control study of consecutive diabetic patients with level 20 DR severity scale score and age-matched healthy subjects. A prototypal OCT-angiography was used to obtain the OCT-angiograms of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris (CC) layer. A validated automated microstructural analysis provided data on SCP, DCP and CC vascular perfusion density (VPD). A comparative assessment between different vascular layers and different groups was performed.

Results

Twenty-nine diabetic patients (7 females, 24%) and 20 healthy controls were enrolled. VPD values were significantly lower in the DCP (25.1% vs. 26.5%; p = 0.04) and CC (71.2% vs. 86.6%; p = 0.0001) of diabetic patients compared with controls. A statistically significant negative linear correlation was reported between CC VPD and DCP VPD in diabetic patients; at the reverse, a positive linear correlation between the same parameters was noticed in controls.

Conclusion

Retinal and choroidal vascular networks, although distinct entities, seem functionally interconnected: varying the degree of perfusion may be a mutual compensatory mechanism in response to an ischemic injury.

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Funding

This study was supported by Fondazione per la Macula Onlus, Genova, Italy, and Fondazione Ferrero, Alba, Italy.

Author information

Author notes

  1. Marco Lupidi and Alessio Cerquaglia have equally contributed to this work.

Authors and Affiliations

  1. Department of Surgical and Biomedical Sciences, Section of Ophthalmology, University of Perugia, S. Maria della Misericordia Hospital, 06156, Perugia, Italy

    Marco Lupidi, Alessio Cerquaglia, Ramkailash Gujar, Tito Fiore & Carlo Cagini

  2. Fondazione per la Macula Onlus, Di.N.O.G.Mi., University Eye Clinic, Viale Benedetto XV 5, 16132, Genoa, Italy

    Marco Lupidi & Felice Cardillo Piccolino

  3. Centre de l’Odéon, 113 Boulevard St Germain, 75006, Paris, France

    Marco Lupidi, Florence Coscas & Gabriel Coscas

  4. Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Jay Chhablani

  5. Department of Internal Medicine, University of Perugia, S. Maria della Misericordia Hospital, 06156, Perugia, Italy

    Daniela Fruttini

Authors
  1. Marco Lupidi
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  2. Alessio Cerquaglia
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  3. Ramkailash Gujar
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  4. Daniela Fruttini
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  5. Felice Cardillo Piccolino
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  6. Tito Fiore
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  7. Florence Coscas
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  8. Gabriel Coscas
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  9. Jay Chhablani
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  10. Carlo Cagini
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Corresponding author

Correspondence to Marco Lupidi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This study was conducted in accordance with the Declaration of Helsinki after approval by the Perugia Institutional Ethics Committee (IEC).

Informed consent

Written informed consent was obtained from all individual participants included in the study.

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This article belongs to the topical collection Eye Complications of Diabetes, managed by Giuseppe Querques.

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Lupidi, M., Cerquaglia, A., Gujar, R. et al. Functional correlation between choroidal and retinal vascularity in low-grade diabetic retinopathy. Acta Diabetol 57, 983–990 (2020). https://doi.org/10.1007/s00592-020-01507-7

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  • DOI: https://doi.org/10.1007/s00592-020-01507-7

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