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Preeti Gupta, Sri Gowtham Thakku, Charumathi Sabanayagam, GAVIN TAN, Gemmy Cheung, Ecosse Luc Lamoureux, Tien Yin Wong, Ching-Yu Cheng; Characterization of Choroidal Morphology and Vasculature in Diabetes and Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2171.
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© ARVO (1962-2015); The Authors (2016-present)
Choroidal morphology and vasculature could be implicated in the pathogenesis of diabetes and diabetic retinopathy (DR), although attempts to quantify and define choroidal structural and vascular characteristics in vivo have been limited. We aim to characterize various morphological and vascular features of the choroid in diabetes and DR.
340 consecutive participants from the Singapore Indian Eye Study during their 6-year follow-up examination underwent choroidal imaging using spectral domain optical coherence tomography (SD-OCT) with enhanced depth imaging. Raw OCT images were loaded on a custom-written application on MATLAB that enabled delineation for detailed morphological and vascular analyses including, the curvature of the choroid-scleral interface (CSI), number of inflection points, choroidal thickness (CT) and choroidal vascular area (VA) at subfovea (1.5 mm) and 6 mm region centered on the fovea. An inflection point represents the contour of the CSI, with >1 point signaling irregular shape. Diabetes was defined as random glucose ≥ 11.1, HbA1C ≥ 6.5, use of diabetic medication or a physician diagnosis of diabetes. DR was defined using the modified Airlie House classification system. Multiple linear regression analyses were performed to assess differences in choroidal characteristics by diabetes and DR.
Of the total 310 subjects analysed in this study, 121 had no diabetes (mean age was 60.1 ± 6.8 years), 100 had diabetes no DR (61.8 ± 7.4 years) and 89 had DR (62.4 ± 6.0 years). In multiple regression analysis, after accounting for relevant confounders, compared to subjects with no diabetes, those with the condition had significantly thinner mean CT (mean difference [MD] = - 32 µm, p = 0.001), more inflection points (MD = 0.982, p = 0.004) and lesser VA at subfovea (MD = - 0.033 mm2, p <0.001) and 6 mm scan region (MD = - 0.120 mm2, p <0.001). However, in comparison to subjects with diabetes, subjects with DR had significantly thicker mean CT (MD = 25.91µm, p = 0.001), less inflection points (MD = -0.647, p = 0.013) and greater VA at subfovea (MD = 0.016 mm2, p = 0.019) and 6 mm scan region (MD = 0.057 mm2, p = 0.016), even after adjusting for potential confounders.
Choroidal morphology and vasculature are altered in subjects with diabetes and DR. These findings may provide insights into choroidal changes in diabetes and DR.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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