The change of subfoveal choroidal thickness in non-proliferative diabetic retinopathy patients_Chinese Journal of Ocular Fundus Diseases

Authors：

 ZangJing , WangWenjuan , ChenLilun , 孙丽 , 鲍炯琳 , 周斌兵 , 朱宇东 , 李青 , 林文雄

Department of Ophthalmology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, China;

Corresponding author：

ZangJing, Email: zang62@yahoo.com

Keywords：

Choroid; Tomography, optical coherence; Diabetic retinopathy

DOI：

10.3760/cma.j.issn.1005-1015.2014.02.003

Video：

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Objective To investigate the change of subfoveal choroidal thickness (SFCT) and the relationship between SFCT and the severity of the diabetic retinopathy using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods A total of 164 eyes (93 patients) of type 2 diabetes mellitus (DM) were included in this study. The patients included 34 males and 59 females, with an average age of (59.3±5.6) years, with an average diabetes duration of (5.11±4.64) years. The patients were divided into 4 groups according to international classification standards of DR, including non-diabetic retinopathy (NDR) group (64 eyes), mild non-proliferative diabetic retinopathy (NPDR) group (33 eyes), moderate NPDR group (37 eyes), and severe NPDR group (30 eyes). The control group included 25 normal subjects (42 eyes). All patients underwent visual acuity, intraocular pressure, slit lamp microscope, indirect ophthalmoscope, A/B-type ultrasound scan, frequency domain optical coherence tomography (SD-OCT) examination, as well as fasting blood glucose and mean arterial blood pressure measurement. The mean axial length was (23.04±0.78) mm, mean fasting blood glucose was (8.88±2.59) mmol/L, mean arterial pressure was (100.44±9.63) mmHg. SFCT of all eyes were measured by EDI-OCT. The relationship between SFCT and the severity of the diabetic retinopathy, DM duration, fasting blood glucose, the mean arterial pressure, axial length was analyzed by one-way ANOVA. Results The mean SFCT was (224.24±42.10) μm in DM group and (276.77±48.07) μm in normal control group, the difference was statistically significant (F=23.86, P < 0.05). The mean SFCT was also statistically significant between all DM groups (P < 0.05). There were negative linear correlation between SFCT of all patients and the severity of retinal lesions (r=-0.555, P=0.000), and between SFCT and DM duration (r=-0.332, P < 0.05). But SFCT was independent of fasting plasma glucose (r=-0.123, P > 0.05), mean arterial pressure (r=-0.116, P > 0.05), and axial length (r=-0.018, P > 0.05). Conclusions SFCT in DM eyes is thinner than that in normal controls. SFCT is different in the NDR, mild NPDR, moderate NPDR, severe NPDR patient. Severe DR patients have much thinner SFCT.

Citation： ZangJing, WangWenjuan, ChenLilun. The change of subfoveal choroidal thickness in non-proliferative diabetic retinopathy patients. Chinese Journal of Ocular Fundus Diseases, 2014, 30(2): 128-131. doi: 10.3760/cma.j.issn.1005-1015.2014.02.003 Copy

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2.	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.
3.	Ikuno Y, Kawaguchi K, Nouchi T, et al. Choroidal thickness in healthy Japanese subjects[J]. Invest Ophthalmol Vis Sci, 2010, 51:2173-2176.
4.	沈胤忱, 许迅, 刘堃.糖尿病黄斑水肿患者黄斑中心凹下脉络膜厚度观察[J].中华眼底病杂志, 2013, 29:9-12.
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7.	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.
8.	American Diabetes Association.Standards of medical care in diabetes--2011[J].Diabetes Care, 2011, 34 Suppl 1:S11-61.
9.	Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J]. Ophthalmology, 2003, 110:1677-1682.
10.	黎晓新.眼的解剖与生理[M]//葛坚.眼科学. 2版.北京:人民卫生出版社, 2010:60-61.
11.	Hidayat AA, Fine BS. Diabetic choroidopathy:light and electron microscopic observations of seven cases[J]. Ophthalmology, 1985, 92:512-522.
12.	Harris AG, Skalak TC, Hatchell DL. Leukocyte-capillary plugging and network resistance are increased in skeletal muscle of rats with streptozotocin-induced hyperglycemia[J]. Int J Microcirc Clin Exp, 1994, 14:159-166.
13.	Nilsson SF. Nitric oxide as a mediator of parasympathetic vasodilation in ocular and extraocular tissues in the rabbit[J]. Invest Ophthalmol Vis Sci, 1996, 37:2110-2119.
14.	曾婧, 刘冉, 张新愉, 等.正常眼后极部脉络膜厚度与性别的研究[J].中华眼科杂志, 2012, 48:1093-1096.
15.	李略, 杨志坤, 董方田.应用增强深部成像的相干光断层扫描测量正常人脉络膜厚度[J].中华眼科杂志, 2012, 48:819-823.
16.	Manjunath V, Taha M, Fujimoto JG, et al. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography[J]. Am J Ophthalmol, 2010, 150:325-329.
17.	Esmaeelpour M, Brunner S, Ansari-Shahrezaei S, et al. Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060 nm optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2012, 53:6803-6809.
18.	Kowluru RA, Chan PS. Metabolic memory in diabetes-from in vitro oddity to in vivo problem:role of apoptosis[J]. Brain Res Bull, 2010, 81:297-302.

1. Coleman DJ, Silverman RH, Chabi A, et al. High-resolution ultrasonic imaging of the posterior segment[J]. Ophthalmology, 2004, 111:1344-1351.
2. 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.
3. Ikuno Y, Kawaguchi K, Nouchi T, et al. Choroidal thickness in healthy Japanese subjects[J]. Invest Ophthalmol Vis Sci, 2010, 51:2173-2176.
4. 沈胤忱, 许迅, 刘堃.糖尿病黄斑水肿患者黄斑中心凹下脉络膜厚度观察[J].中华眼底病杂志, 2013, 29:9-12.
5. 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.
6. Regatieri CV, Branchini L, Carmody J, et al. Choroidal thickness in patients with diabetic rerinopathy analyzed by spectral-domain optical coherence tomography[J].Retina, 2012, 32:563-568.
7. 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.
8. American Diabetes Association.Standards of medical care in diabetes--2011[J].Diabetes Care, 2011, 34 Suppl 1:S11-61.
9. Wilkinson CP, Ferris FL 3rd, Klein RE, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J]. Ophthalmology, 2003, 110:1677-1682.
10. 黎晓新.眼的解剖与生理[M]//葛坚.眼科学. 2版.北京:人民卫生出版社, 2010:60-61.
11. Hidayat AA, Fine BS. Diabetic choroidopathy:light and electron microscopic observations of seven cases[J]. Ophthalmology, 1985, 92:512-522.
12. Harris AG, Skalak TC, Hatchell DL. Leukocyte-capillary plugging and network resistance are increased in skeletal muscle of rats with streptozotocin-induced hyperglycemia[J]. Int J Microcirc Clin Exp, 1994, 14:159-166.
13. Nilsson SF. Nitric oxide as a mediator of parasympathetic vasodilation in ocular and extraocular tissues in the rabbit[J]. Invest Ophthalmol Vis Sci, 1996, 37:2110-2119.
14. 曾婧, 刘冉, 张新愉, 等.正常眼后极部脉络膜厚度与性别的研究[J].中华眼科杂志, 2012, 48:1093-1096.
15. 李略, 杨志坤, 董方田.应用增强深部成像的相干光断层扫描测量正常人脉络膜厚度[J].中华眼科杂志, 2012, 48:819-823.
16. Manjunath V, Taha M, Fujimoto JG, et al. Choroidal thickness in normal eyes measured using Cirrus HD optical coherence tomography[J]. Am J Ophthalmol, 2010, 150:325-329.
17. Esmaeelpour M, Brunner S, Ansari-Shahrezaei S, et al. Choroidal thinning in diabetes type 1 detected by 3-dimensional 1060 nm optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2012, 53:6803-6809.
18. Kowluru RA, Chan PS. Metabolic memory in diabetes-from in vitro oddity to in vivo problem:role of apoptosis[J]. Brain Res Bull, 2010, 81:297-302.

Chinese Journal of Ocular Fundus Diseases

The change of subfoveal choroidal thickness in non-proliferative diabetic retinopathy patients

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