Three-dimensional choroidal changes in diabetes and diabetic retinopathy: An ultrawide-field swept-source optical coherence tomography angiography study

IF 2.7 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Microvascular research Pub Date : 2025-06-20 DOI:10.1016/j.mvr.2025.104832

Zhaoxia Zheng , Lei Hu , Yue Zhang , Nianen Liu , Xiaoya Gu , Shuang Song , Xiaobing Yu

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引用次数: 0

Abstract

Purpose

To investigate choroidal changes in different stages of diabetic retinopathy (DR), and determine the effect of panretinal photocoagulation (PRP) on choroid based on volumetric measurements of ultrawide-field swept-source optical coherence tomography angiography (UWF-SS-OCTA).

Methods

This observational study included 56 healthy controls, 192 treatment-naïve DR patients, and 42 PRP-treated DR patients who have undergone UWF-SS-OCTA measurements. Treatment-naïve DR patients were further grouped according to varying severity of DR. Choroidal parameters were analyzed and compared among these groups according to central and peripheral areas. Spearman analysis was performed to determine the association between non-perfusion area (NPA) and choroidal parameters.

Results

Compared with healthy controls, choroidal thickness (CT) and volume (CV), including both vascular and stromal volume (CVV/a and CSV/a) were decreased in treatment-naïve DR patients in full range, while choroidal vascularity index (CVI) decreased only in the peripheral area (P = 0.04). In detail, choroid was thinning in no-DR (NDR) and mild NPDR, followed by an increased trend in moderate and late stages of DR. NPA was positively associated with CT, CV, CVV/a, and CSV/a in moderate and late stages of DR. Choroidal parameters decreased in PRP-treated eyes except for an increase of CVI in the central area.

Conclusion

Choroid was thinning in treatment-naïve DR eyes. Specifically, choroid decreased in the early stage and further increased with DR progression; increased expression of VEGF may be a key factor in choroidal thickening. PRP treatment could contribute to the redistribution of choroidal blood flow and improve the perfusion of the macula.

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糖尿病和糖尿病视网膜病变的三维脉络膜改变：一项超宽视场扫描源光学相干断层血管造影研究

目的探讨糖尿病视网膜病变（DR）不同阶段脉络膜的变化，并通过超宽视场扫描源光学相干断层血管造影（UWF-SS-OCTA）的体积测量来确定全视网膜光凝（PRP）对脉络膜的影响。方法本观察性研究包括56名健康对照、192名treatment-naïve DR患者和42名接受prp治疗的DR患者，这些患者接受了UWF-SS-OCTA测量。Treatment-naïve将DR患者根据DR的严重程度进行分组，并根据中心区和外周区对各组脉络膜参数进行分析和比较。采用Spearman分析确定非灌注面积（NPA）与脉络膜参数之间的关系。结果与健康对照组相比，treatment-naïve DR患者脉络膜厚度（CT）和体积（CV），包括血管和间质体积（CVV/a和CSV/a）均全面降低，脉络膜血管指数（CVI）仅在外周区降低（P = 0.04）。在无dr （NDR）和轻度NPDR中脉络膜变薄，随后在dr中晚期呈增加趋势。NPA与dr中晚期CT、CV、CVV/a和CSV/a呈正相关，prp治疗的眼睛脉络膜参数下降，但中心区域CVI增加。结论treatment-naïve DR眼脉络膜变薄。具体来说，脉络膜在早期减少，随着DR的进展进一步增加；VEGF表达增加可能是脉络膜增厚的关键因素。PRP治疗有助于脉络膜血流的重新分布，改善黄斑的血流灌注。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microvascular research 医学-外周血管病

CiteScore

6.00

自引率

3.20%

发文量

158

审稿时长

43 days

期刊介绍： Microvascular Research is dedicated to the dissemination of fundamental information related to the microvascular field. Full-length articles presenting the results of original research and brief communications are featured. Research Areas include: • Angiogenesis • Biochemistry • Bioengineering • Biomathematics • Biophysics • Cancer • Circulatory homeostasis • Comparative physiology • Drug delivery • Neuropharmacology • Microvascular pathology • Rheology • Tissue Engineering.