Sub-foveal choroidal thickness of type 2 diabetic patients with diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

FanWen , SunXinghong , NieQiao , 杭荟 , 邵庆 ,  刘庆淮

Department of Ophthalmology, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China;

Corresponding author：

刘庆淮, Email: liuqh@njmu.edu.cn

Keywords：

Choroid; Tomography, optical coherence; Diabetic retinopathy

DOI：

10.3760/cma.j.issn.1005-1015.2014.02.002

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Objective To observe the changes in choroidal thickness in type 2 diabetes patients with diabetic retinopathy (DR). Methods A total of 227 eyes from 150 type 2 diabetes patients were enrolled in this study. The patients included 67 males (89 eyes) and 83 females (138 eyes). The mean age was (65.6±8.0) years, and the mean diabetes duration was (12.4±6.5) years. All the patients were examined for best corrected visual acuity (BCVA), diopter, slit lamp ophthalmoscopy, indirect ophthalmoscopy and spectral domain optical coherence tomography (SD-OCT) examination. The patients were divided into non-DR (NDR group, 99 eyes), non-proliferative DR (PDR) without macular edema (ME) group (NPDR/ME-group, 64 eyes), non-PDR with ME group (NPDR/ME+ group, 5 eyes), PDR without ME group (PDR/ME-group, 25 eyes), PDR with ME group (PDR/ME+ group, 5 eyes) according to the Early Treatment Diabetic Retinopathy Study. The ones having a history of pan-retinal photocoagulation (PRP) were classified as PRP-DR. Age-matched normal subjects were enrolled as the control group. Sub-foveal choroidal thickness (SFCT) was measured by SD-OCT with enhanced depth imaging (EDI). Results Mean SFCT was (310.2±54.8), (251.1±81.4), (262.5±83.2), (286.2±76.8) and (327.4±83.1) μm respectively in control, NDR, NPDR/ME-, PDR/ME-and PRP-DR groups. Mean SFCT decreased significantly in NDR and NPDR/ME-group (t=2.754, 2.140; P < 0.05). Mean SFCT in PDR/ME-group was thicker than that in NDR (t=-2.114, P < 0.05). Mean SFCT in PRP-DR group was thicker than that in PDR/ME-group (U=271.500, P < 0.05). Conclusion SFCT decreased during the early course of diabetics and increased significantly as the severity worsened from NDR to PDR, and increased in the early duration after PRP treatment.

Citation： FanWen, SunXinghong, NieQiao. Sub-foveal choroidal thickness of type 2 diabetic patients with diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2014, 30(2): 124-127. doi: 10.3760/cma.j.issn.1005-1015.2014.02.002 Copy

1.	Kim JT, Lee DH, Joe SG, et al. Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients[J]. Invest Ophthalmol Vis Sci, 2013, 54:3378-3384.
2.	Querques G, Lattanzio R, Querques L, et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes[J]. Invest Ophthalmol Vis Sci, 2012, 53:6017-6024.
3.	Regatieri CV, Branchini L, Carmody J, et al. Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography[J].Retina, 2012, 32:563-568.
4.	Vujosevic S, Martini F, Cavarzeran F, et al. Macular and peripapillary choroidal thickness in diabetic patients[J]. Retina, 2012, 32:1781-1790.
5.	Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med, 1998, 15:539-553.
6.	Early Treatment Diabetic Retinopathy Study Research Group.Grading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification:ETDRS report number 10[J]. Ophthalmology, 1991, 98:786-806.
7.	Cao J, Mcleod S, Merges CA, et al. Choriocapillaris degeneration and related pathologic changes in human diabetic eyes[J]. Arch Ophthalmol, 1998, 116:589-597.
8.	Rahman W, Chen FK, Yeoh J, et al. Repeatability of manual subfoveal choroidal thickness measurements in healthy subjects using the technique of enhanced depth imaging optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2011, 52:2267-2271.
9.	Manjunath V, Taha M, Fujimoto J G, et al. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography[J]. Am J Ophthalmol, 2010, 150:325-329.
10.	Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography[J]. Am J Ophthalmol, 2008, 146:496-500.
11.	Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes[J]. Am J Ophthalmol, 2009, 147:811-815.
12.	曾婧, 丁小燕, 李加青, 等.中国人黄斑区脉络膜厚度值及其影响因素分析[J].中华眼底病杂志, 2011, 27:450-453.
13.	Yülek F, Uğurlu N, Onal ED, et al.Choroidal changes and duration of diabetes[J/OL].Semin Ophthalmol, 2013, 2013:E821504[2013-09-27].http://informahealthcare.com/doi/abs/10.3109/08820538.
14.	Esmaeelpour M, Povazay B, Hermann B, et al. Mapping choroidal and retinal thickness variation in type 2 diabetes using three-dimensional 1060-nm optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2011, 52:5311-5316.
15.	Lutty GA, Cao J, Mcleod DS. Relationship of polymorphonuclear leukocytes to capillary dropout in the human diabetic choroid[J]. Am J Pathol, 1997, 151:707-714.
16.	Geyer O, Neudorfer M, Snir T, et al. Pulsatile ocular blood flow in diabetic retinopathy[J]. Acta Ophthalmol Scand, 1999, 77:522-525.
17.	Aiello LP, Northrup JM, Keyt BA, et al. Hypoxic regulation of vascular endothelial growth factor in retinal cells[J]. Arch Ophthalmol, 1995, 113:1538-1544.
18.	Nagaoka T, Kitaya N, Sugawara R, et al. Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes[J]. Br J Ophthalmol, 2004, 88:1060-1063.
19.	Savage HI, Hendrix JW, Peterson DC, et al. Differences in pulsatile ocular blood flow among three classifications of diabetic retinopathy[J]. Invest Ophthalmol Vis Sci, 2004, 45:4504-4509.
20.	Takahashi A, Nagaoka T, Sato E, et al. Effect of panretinal photocoagulation on choroidal circulation in the foveal region in patients with severe diabetic retinopathy[J]. Br J Ophthalmol, 2008, 92:1369-1373.
21.	Oster SF, Mojana F, Brar M, et al. Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes[J]. Retina, 2010, 30:713-718.

1. Kim JT, Lee DH, Joe SG, et al. Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients[J]. Invest Ophthalmol Vis Sci, 2013, 54:3378-3384.
2. Querques G, Lattanzio R, Querques L, et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes[J]. Invest Ophthalmol Vis Sci, 2012, 53:6017-6024.
3. Regatieri CV, Branchini L, Carmody J, et al. Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography[J].Retina, 2012, 32:563-568.
4. Vujosevic S, Martini F, Cavarzeran F, et al. Macular and peripapillary choroidal thickness in diabetic patients[J]. Retina, 2012, 32:1781-1790.
5. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J]. Diabet Med, 1998, 15:539-553.
6. Early Treatment Diabetic Retinopathy Study Research Group.Grading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification:ETDRS report number 10[J]. Ophthalmology, 1991, 98:786-806.
7. Cao J, Mcleod S, Merges CA, et al. Choriocapillaris degeneration and related pathologic changes in human diabetic eyes[J]. Arch Ophthalmol, 1998, 116:589-597.
8. Rahman W, Chen FK, Yeoh J, et al. Repeatability of manual subfoveal choroidal thickness measurements in healthy subjects using the technique of enhanced depth imaging optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2011, 52:2267-2271.
9. Manjunath V, Taha M, Fujimoto J G, et al. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography[J]. Am J Ophthalmol, 2010, 150:325-329.
10. Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography[J]. Am J Ophthalmol, 2008, 146:496-500.
11. Margolis R, Spaide RF. A pilot study of enhanced depth imaging optical coherence tomography of the choroid in normal eyes[J]. Am J Ophthalmol, 2009, 147:811-815.
12. 曾婧, 丁小燕, 李加青, 等.中国人黄斑区脉络膜厚度值及其影响因素分析[J].中华眼底病杂志, 2011, 27:450-453.
13. Yülek F, Uğurlu N, Onal ED, et al.Choroidal changes and duration of diabetes[J/OL].Semin Ophthalmol, 2013, 2013:E821504[2013-09-27].http://informahealthcare.com/doi/abs/10.3109/08820538.
14. Esmaeelpour M, Povazay B, Hermann B, et al. Mapping choroidal and retinal thickness variation in type 2 diabetes using three-dimensional 1060-nm optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2011, 52:5311-5316.
15. Lutty GA, Cao J, Mcleod DS. Relationship of polymorphonuclear leukocytes to capillary dropout in the human diabetic choroid[J]. Am J Pathol, 1997, 151:707-714.
16. Geyer O, Neudorfer M, Snir T, et al. Pulsatile ocular blood flow in diabetic retinopathy[J]. Acta Ophthalmol Scand, 1999, 77:522-525.
17. Aiello LP, Northrup JM, Keyt BA, et al. Hypoxic regulation of vascular endothelial growth factor in retinal cells[J]. Arch Ophthalmol, 1995, 113:1538-1544.
18. Nagaoka T, Kitaya N, Sugawara R, et al. Alteration of choroidal circulation in the foveal region in patients with type 2 diabetes[J]. Br J Ophthalmol, 2004, 88:1060-1063.
19. Savage HI, Hendrix JW, Peterson DC, et al. Differences in pulsatile ocular blood flow among three classifications of diabetic retinopathy[J]. Invest Ophthalmol Vis Sci, 2004, 45:4504-4509.
20. Takahashi A, Nagaoka T, Sato E, et al. Effect of panretinal photocoagulation on choroidal circulation in the foveal region in patients with severe diabetic retinopathy[J]. Br J Ophthalmol, 2008, 92:1369-1373.
21. Oster SF, Mojana F, Brar M, et al. Disruption of the photoreceptor inner segment/outer segment layer on spectral domain-optical coherence tomography is a predictor of poor visual acuity in patients with epiretinal membranes[J]. Retina, 2010, 30:713-718.

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