Comparison of choroidal thickness in eyes of diabetic patients with eyes of healthy individuals using optical coherence tomography in a tertiary care hospital

Hafsa Hassan, Alyscia Cheema, Muhammad Ali Tahir, Hina Nasreen Nawaz, Hafsa Hassan, Alyscia Cheema, Muhammad Ali Tahir, Hina Nasreen Nawaz

Abstract

Objectives: To compare the choroidal thickness in eyes of diabetic patients with eyes of age matched controls using optical coherence tomography in a tertiary care hospital.

Methods: This Cross sectional study was conducted at the Department of Ophthalmology, Jinnah Postgraduate Medical Centre Karachi, for six months from13thJanuary 2020 to13thJuly 2020. The study group comprised of 44 patients with 88 eyes. Patients who fulfill the inclusion criteria that is age ranging from 35 to 80years, either gender, known case of diabetes mellitus and having any type of diabetic retinopathy (HbA1c >7), non-diabetic healthy individuals (HbA1c < 7) and those giving informed consent were included in the study. However, patients having active ocular infections, history of myocardial infarction, stroke, uveitis, any ocular surgery, lasers, intravitreal injections, poor fundus view and not giving consent were excluded. A pre-designed proforma was filled. A baseline ocular examination was performed and choroidal thickness was assessed from retinal pigment epithelium to choroid sclera junction in diabetic and healthy participants of the study group using high resolution Swept source OCT (DRI-OCT-2 Triton; Topcon).

Results: The average age of the patients was 39.41±15.95 years. According to our study mean central subfoveal choroidal thickness in diabetic eyes was 268.5 ± 66.22 (95% CI 240 - 297) and in non-diabetic healthy participants it was 339.3 ± 71.49 (95% CI 308 - 369) with a p-value of 0.001. However, average choroidal thickness was 261.8 ± 61.93 (95% CI 235 - 288) and 336.0 ± 74.35 (95% CI 304 - 367) in diabetic and non-diabetic healthy population with a p-value of 0.001. Choroidal thickness comparison between gender in diabetic and non-diabetic population also showed similar trend.

Conclusion: In this study, mean central choroidal thickness as well as average choroidal thickness was significantly reduced in eyes having diabetic retinopathy as compared to participants with non-diabetic healthy eyes. These findings indicate that changes in choroid may be a probable route in the pathogenesis of diabetic retinopathy.

Keywords: Choroidal thickness; Diabetic retinopathy; Swept source optical coherence tomography.

Copyright: © Pakistan Journal of Medical Sciences.

Figures

Fig.1
Fig.1
OCT image of a diabetic patient having PDR with DME illustrating choroidal thickness.
Fig.2
Fig.2
OCT image of a non diabetic healthy individual in our study group.

References

    1. Kim JT, Lee DH, Joe SG, Kim JG, Yoo YH. Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci. 2013;54(5):3378–3784.
    1. Adhi M, Brewer E, Waheed NK, Duker JS. Analysis of morphological features and vascular layers of choroid in diabetic retinopathy using spectral-domain optical coherence tomography. JAMA Ophthalmol. 2013;131(10):1267–1274.
    1. Antonetti DA, Klein R, Gardner TW. Diabetic retinopathy. N Engl J Med. 2012;366(13):1227–1239.
    1. KurJ Newman EA, Chan-Ling T. Cellular and physiological mechanisms underlying blood flow regulation in the retina and choroid in health and disease. Prog Retin Eye Res. 2012;31(5):377–406.
    1. Lee HK, Lim JW, Shin MC. Comparison of choroidal thickness in patients with diabetes by spectral-domain optical coherence tomography. Korean J Ophthalmol. 2013;27(6):433–439.
    1. Weinberger D, Kramer M, Priel E. Indocyanine green angiographic findings in nonproliferative diabetic retinopathy. Am J Ophthalmol. 1998;126:238–247.
    1. Gerendas BS, Waldstein SM, Simader C, DeakG Hajnajeeb B, Zhang L, et al. Three-dimensional automated choroidal volume assessment on standard spectral-domain optical coherence tomography and correlation with the level of diabetic macular edema. Am J Ophthalmol. 2014;158(5):1039–1048.
    1. Regatieri CV, Branchini L, Carmody J, Fujimoto JG, Duker JS. Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina. 2012;32(3):563–568.
    1. Cao J, Mc Leod S, Merges CA, Lutty GA. Chorio capillaris degeneration and related pathologic changes in human diabetic eyes. Arch Ophthalmol. 1998;116:589–597.
    1. MacGregor LC, Rosecan LR, Laties AM, Matschinsky FM. Altered retinal metabolism in diabetes. I. Microanalysis of lipid, glucose, sorbitol, and myoinositol in the choroid and in the individual layers of the rabbit retina. J Biol Chem. 1986;261:4046–4051.
    1. Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol. 2009;147:811–815.
    1. Yeoh J, Rahman W, Chen F, Hooper C, Patel P, Tufail A, et al. Choroidal imaging in inherited retinal disease using the technique of enhanced depth imaging optical coherence tomography. Graefes Arch Clin Exp Ophthalmol. 2010;248:1719–1728.
    1. Nagaoka T, Kitaya N, Sugawara R, Yokota H, Mori F, Hikichi T, et al. Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes. Br J Ophthalmol. 2004;88:1060–1063.
    1. Schocket LS, Brucker AJ, Niknam RM, Grunwald JE, Du Pont J, Brucker AJ. Foveolar choroidal hemodynamics in proliferative diabetic retinopathy. Int Ophthalmol. 2004;25:89–94.
    1. Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes. Am J Ophthalmol. 2009;147:811–815.
    1. Fujiwara T, Imamura Y, Margolis R, Slakter JS, Spaide RF. Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes. Am J Ophthalmol. 2009;148:445–450.
    1. El Ghonemy K, Rajab GZ, Ibrahim AM, Gohar IM. Comparison between choroidal thickness in patients with diabetic retinopathy and normal individuals using enhanced depth imaging spectral- domain optical coherence tomography. Delta J Ophthalmol. 2018;19:53–57.
    1. Wang W, Liu S, Qiu Z. Choroidal thickness in diabetes and diabetic retinopathy:a swept source OCT study. Invest Ophthalmol Vis Sci. 2020;61(4):29.
    1. Lains I, Talcott KE, Santos AR. Choroidal thickness in diabetic retinopathy assessed with swept-source optical coherence tomography. Retina. 2018;38:173–182.
    1. Horvath H, Kovacs I, Sandor GL. Choroidal thickness changes in non-treated eyes of patients with diabetes:Swept-source optical coherence tomography study. Acta Diabetol. 2018;55:927–934.
    1. Ambiya V, Kumar A, Baranwal VK. Change in subfoveal choroidal thickness in diabetes and in various grades of diabetic retinopathy. Int J Retina Vitreous. 2018;4:34.
    1. Tavares FJ, Vicente A, Proenca R. Choroidal thickness in diabetic patients without diabetic retinopathy. Retina. 2018;38:795–804.
    1. Xu J, Xu L, Du KF. Subfoveal choroidal thickness in diabetes and diabetic retinopathy. Ophthalmology. 2013;120:2023–2028.
    1. Wang JC, Lains I, Providencia J. Diabetic choroidopathy:choroidal vascular density and volume in diabetic retinopathy with swept-source optical coherence tomography. Am J Ophthalmol. 2017;184:75–83.
    1. Zhang X, Ma J, Wang Y. Elevated serum IGF-1 level enhances retinal and choroidal thickness in untreated acromegaly patients. Endocrine. 2018;59:634–642.
    1. Nomura Y, Takahashi H, Fujino Y, Kawashima H, Yanagi Y. Association between aqueous humor cxc motif chemokine ligand 13 levels and subfoveal choroidal thickness in normal older subjects. Retina. 2016;36:192–198.
    1. Yokouchi H, Baba T, Misawa S. Correlation between serum level of vascular endothelial growth factor and subfoveal choroidal thickness in patients with POEMS syndrome. Graefes Arch Clin Exp Ophthalmol. 2015;253:1641–1646.
    1. Querques G, Lattanzio R, Querques L. Enhanced depth imaging optical coherence tomography in type 2 diabetes. Invest Ophthalmol Vis Sci. 2012;53:6017–6024.

Source: PubMed

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