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Tarek Alasil, Daniela Ferrara, Mehreen Adhi, Martin F Kraus, Caroline R Baumal, Andre J Witkin, Jonathan Jaoshin Liu, James G Fujimoto, Nadia K Waheed, Jay S Duker; En Face Imaging of the Choroid in Diabetic Retinopathy using Swept-Source Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3412.
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© ARVO (1962-2015); The Authors (2016-present)
To define the choroidal layers in eyes with diabetic retinopathy (DR) using en face images from swept-source optical coherence tomography (SS-OCT).
Diabetic and age-matched normal subjects were prospectively scanned with a prototype SS-OCT system obtaining 100,000 A-lines/sec at a wavelength of 1050nm and axial resolution of 6 µm. A motion correction algorithm was applied to merge the 12x12 mm scans into a single volumetric dataset. Scans were flattened using the RPE/Bruch's membrane complex as a reference, to facilitate en face image generation at an interval of 4.13 µm (1 pixel) starting from the RPE. Choroidal layers were qualitatively and quantitatively characterized.
Thirty seven eyes from 27 subjects with DR were enrolled; 22 eyes had non-proliferative DR and 15 eyes had proliferative DR; Best corrected visual acuity (BCVA) ranged from 20/20 to 20/200. Twenty two eyes from 13 normal subjects were enrolled with BCVA of 20/20 or better. Systemic analysis of en face SS-OCT images was used to define the choriocapillaris (CC), inner choroid (IC), and outer choroid (OC). In the DR group, the mean thickness ± standard deviation (SD) of each layer was: CC (40.4 ± 11.0 µm), IC (43.6 ±19.7 µm), and OC (205.0 ± 45.9 µm). In the normal group, the mean thickness ± SD of each layer was: CC (64.2 ± 23.9 µm), IC (67.4µm ± 22.2 µm), and OC (233.9 ± 5.2 µm). CC and IC were significantly thinner in the diabetic group when compared to the normal group (p < 0.001). In the DR group, the mean proportion of each layer of the total choroidal thickness was: CC 14%, IC 15%, and OC 71%. In the normal group, the mean proportion of each layer was: CC 18%, IC 18%, and OC 64%. The CC and IC contributions to the total choroidal thickness were significantly less in the diabetic eyes when compared to the normal eyes (p= 0.007, p= 0.009, respectively). The OC contribution to the total choroidal thickness was significantly higher in the diabetic eyes when compared to normal eyes (p< 0.001).
DR eyes had thinner choroids when compared to normal eyes. CC and IC contributed less to the total choroidal thickness in DR when compared to normal subjects. En face SS-OCT might provide a useful tool to better understand the pathophysiology of diabetic choroidopathy.
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