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Erschienen in: Journal of Endocrinological Investigation 5/2024

22.11.2023 | Original Article

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

verfasst von: Ç. Keskin, E. N. A. Dilekçi, A. Y. Üçgül, R. K. Üçgül, G. Toprak, D. Cengiz

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 5/2024

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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.
Literatur
1.
Zurück zum Zitat 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):2465–2474CrossRefPubMed 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):2465–2474CrossRefPubMed
2.
Zurück zum Zitat Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414(6865):782–787CrossRefPubMed Zimmet P, Alberti KG, Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414(6865):782–787CrossRefPubMed
3.
Zurück zum Zitat Klein BE (2007) Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol 14(4):179–183CrossRefPubMed Klein BE (2007) Overview of epidemiologic studies of diabetic retinopathy. Ophthalmic Epidemiol 14(4):179–183CrossRefPubMed
4.
Zurück zum Zitat 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):1274–1277CrossRefPubMed 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):1274–1277CrossRefPubMed
5.
Zurück zum Zitat Lovasik JV, Kergoat H (1993) Electroretinographic results and ocular vascular perfusion in type 1 diabetes. Investig Ophthalmol Vis Sci 34(5):1731–1743 Lovasik JV, Kergoat H (1993) Electroretinographic results and ocular vascular perfusion in type 1 diabetes. Investig Ophthalmol Vis Sci 34(5):1731–1743
6.
Zurück zum Zitat 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 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
7.
Zurück zum Zitat 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):563–568CrossRefPubMedPubMedCentral 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):563–568CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat 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):5260–5266CrossRef 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):5260–5266CrossRef
9.
Zurück zum Zitat Vujosevic S, Martini F, Cavarzeran F, Pilotto E, Midena E (2012) Macular and peripapillary choroidal thickness in diabetic patients. Retina 32(9):1781–1790CrossRefPubMed Vujosevic S, Martini F, Cavarzeran F, Pilotto E, Midena E (2012) Macular and peripapillary choroidal thickness in diabetic patients. Retina 32(9):1781–1790CrossRefPubMed
10.
Zurück zum Zitat 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):2023–2028CrossRefPubMed 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):2023–2028CrossRefPubMed
11.
Zurück zum Zitat 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) 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.
Zurück zum Zitat 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):3563–3569CrossRef 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):3563–3569CrossRef
13.
Zurück zum Zitat Hidayat AA, Fine BS (1985) Diabetic choroidopathy. Light and electron microscopic observations of seven cases. Ophthalmology 92(4):512–522CrossRefPubMed Hidayat AA, Fine BS (1985) Diabetic choroidopathy. Light and electron microscopic observations of seven cases. Ophthalmology 92(4):512–522CrossRefPubMed
14.
Zurück zum Zitat 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):436–442CrossRefPubMed 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):436–442CrossRefPubMed
15.
Zurück zum Zitat 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):e10871PubMedPubMedCentral 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):e10871PubMedPubMedCentral
16.
17.
Zurück zum Zitat 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):70CrossRefPubMedPubMedCentral 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):70CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat 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–e616CrossRefPubMed 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–e616CrossRefPubMed
19.
Zurück zum Zitat 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):912–916CrossRefPubMedPubMedCentral 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):912–916CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Unsal E, Eltutar K, Zirtiloglu S, Dincer N, OzdoganErkul S, Gungel H (2014) Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol 8:637–642CrossRefPubMedPubMedCentral Unsal E, Eltutar K, Zirtiloglu S, Dincer N, OzdoganErkul S, Gungel H (2014) Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol 8:637–642CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat 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):1568–1572CrossRef 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):1568–1572CrossRef
Metadaten
Titel
Choroidal vascularity index as a predictor for the development of retinopathy in diabetic patients
verfasst von
Ç. Keskin
E. N. A. Dilekçi
A. Y. Üçgül
R. K. Üçgül
G. Toprak
D. Cengiz
Publikationsdatum
22.11.2023
Verlag
Springer International Publishing
Erschienen in
Journal of Endocrinological Investigation / Ausgabe 5/2024
Elektronische ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-023-02236-8

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