open access
Subfoveal Choroidal and Macular Thickness Assessed with Optical Coherence Tomography in Indonesian Subjects with Type 2 Diabetes: A Cross-Sectional Study
Affiliations- Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Cicendo National Eye Center Hospital, Bandung, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
open access
Abstract
Objective: The present study aims to assess the difference in choroidal and macular thickness in type 2 diabetes (T2D) patients with and without diabetic retinopathy (DR). Materials and methods: This cross-sectional analytic study included 84 eyes from 56 subjects by consecutive sampling which were divided into control, T2D without DR/non-diabetic retinopathy (NDR), and T2D with DR/diabetic retinopathy (DR) group. The subjects were patients with T2D aged 40–60 years with or without DR, with normal intraocular pressure, and never received any DR therapy. The data collected were age, gender, mean arterial pressure, glycemic control, choroidal thickness (CT), and macular thickness (MT). Results: Mean age of the NDR group was 51.67 ± 4.64 years, the DR group was 52.45 ± 4.46 years, and the control group was 51.31 ± 5.72 years. Subjects in DR group (247.57 ± 57.95 microns) had significantly thinner choroids when compared to the NDR group (266.68 ± 51.76 microns), they both also had significantly thinner choroids when compared to the control group (283.07 ± 69.98; p = 0.042). On the contrary, subjects in DR group (263.79 ± 45.17 microns) had thicker macula compared to the NDR (236.11 ± 26.49 microns) and control group (239.82 ± 17.42 microns; p = 0.015). Conclusions: Subjects with type 2 diabetes and retinopathy had significantly thinner choroid and thicker macula when compared to non-diabetic retinopathy group. The thinning of choroid and thickening of macula develops as the disease progresses to diabetic retinopathy.
Abstract
Objective: The present study aims to assess the difference in choroidal and macular thickness in type 2 diabetes (T2D) patients with and without diabetic retinopathy (DR). Materials and methods: This cross-sectional analytic study included 84 eyes from 56 subjects by consecutive sampling which were divided into control, T2D without DR/non-diabetic retinopathy (NDR), and T2D with DR/diabetic retinopathy (DR) group. The subjects were patients with T2D aged 40–60 years with or without DR, with normal intraocular pressure, and never received any DR therapy. The data collected were age, gender, mean arterial pressure, glycemic control, choroidal thickness (CT), and macular thickness (MT). Results: Mean age of the NDR group was 51.67 ± 4.64 years, the DR group was 52.45 ± 4.46 years, and the control group was 51.31 ± 5.72 years. Subjects in DR group (247.57 ± 57.95 microns) had significantly thinner choroids when compared to the NDR group (266.68 ± 51.76 microns), they both also had significantly thinner choroids when compared to the control group (283.07 ± 69.98; p = 0.042). On the contrary, subjects in DR group (263.79 ± 45.17 microns) had thicker macula compared to the NDR (236.11 ± 26.49 microns) and control group (239.82 ± 17.42 microns; p = 0.015). Conclusions: Subjects with type 2 diabetes and retinopathy had significantly thinner choroid and thicker macula when compared to non-diabetic retinopathy group. The thinning of choroid and thickening of macula develops as the disease progresses to diabetic retinopathy.
Keywords
choroid, choroidal thickness, macular thickness, type 2 diabetes mellitus, diabetic retinopathy
About this articleTitle
Subfoveal Choroidal and Macular Thickness Assessed with Optical Coherence Tomography in Indonesian Subjects with Type 2 Diabetes: A Cross-Sectional Study
Journal
Issue
Article type
Research paper
Pages
80-86
Published online
2023-01-27
Page views
519
Article views/downloads
63
DOI
10.5603/DK.a2022.0064
Bibliographic record
CD 2023;12(2):80-86.
Keywords
choroid
choroidal thickness
macular thickness
type 2 diabetes mellitus
diabetic retinopathy
Authors
Raden Maula Rifada
Joan Sherlone T. Hutabarat
Andika Prahasta
Bachti Alisjahbana
Arief S. Kartasasmita
References (38)- Teo Z, Tham YC, Yu M, et al. Global prevalence of diabetic retinopathy and projection of burden through 2045. Ophthalmology. 2021; 128(11): 1580–1591.
- Khalil H. Diabetes microvascular complications - a clinical update. Diabetes Metab Syndr. 2017; 11 Suppl 1: S133–S139.
- Sasongko MB, Widyaputri F, Agni AN, et al. Prevalence of diabetic retinopathy and blindness in indonesian adults with type 2 diabetes. Am J Ophthalmol. 2017; 181: 79–87.
- Duh EJ, Sun JK, Stitt AW. Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. JCI Insight. 2017; 2(14): e93751.
- Melancia D, Vicente A, Cunha JP, et al. Diabetic choroidopathy: a review of the current literature. Graefes Arch Clin Exp Ophthalmol. 2016; 254(8): 1453–1461.
- Lutty GA. Diabetic choroidopathy. Vision Res. 2017; 139: 161–167.
- Xu HZ, Song Z, Fu S, et al. RPE barrier breakdown in diabetic retinopathy: seeing is believing. J Ocul Biol Dis Infor. 2011; 4(1-2): 83–92.
- Le YZ. VEGF production and signaling in Müller glia are critical to modulating vascular function and neuronal integrity in diabetic retinopathy and hypoxic retinal vascular diseases. Vision Res. 2017; 139: 108–114.
- Seo EJ, Moon TH, Kim DY, et al. Choroidal inflammation and choriocapillaris ischemia in focal choroidal excavation in comparison to pachychoroid neovasculopathy. Retina. 2021; 41(5): 987–996.
- Kase S, Endo H, Takahashi M, et al. Alteration of choroidal vascular structure in diabetic retinopathy. Br J Ophthalmol. 2020; 104(3): 417–421.
- Wang B, Wang F, Zhang Y, et al. Effects of RAS inhibitors on diabetic retinopathy: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2015; 3(4): 263–274.
- Action to Control Cardiovascular Risk in Diabetes Follow-On (ACCORDION) Eye Study Group and the Action to Control Cardiovascular Risk in Diabetes Follow-On (ACCORDION) Study Group. Persistent effects of intensive glycemic control on retinopathy in type 2 diabetes in the action to control cardiovascular risk in diabetes (ACCORD) follow-on study. Diabetes Care. 2016; 39(7): 1089–1100.
- Huang X, Zhang P, Zou X, et al. Thinner average choroidal thickness is a risk factor for the onset of diabetic retinopathy. Ophthalmic Res. 2020; 63(3): 259–270.
- Wei Q, Qiu W, Liu Q, et al. Relationship between risk factors and macular thickness in patients with early diabetic retinopathy. Int J Gen Med. 2022; 15: 6021–6029.
- Waisberg V, Rodrigues L, Nehemy M, et al. Spectral-Domain Optical Coherence Tomography Findings in Neurofibromatosis Type 2. Investig Ophthalmol Vis Sci. 2016; 57(9): OCT262.
- Ghassemi F, Berijani S, Babeli A, et al. The quantitative measurements of choroidal thickness and volume in diabetic retinopathy using optical coherence tomography and optical coherence tomography angiography; correlation with vision and foveal avascular zone. BMC Ophthalmol. 2022; 22(1): 3.
- Sareddy C, Nagpal S, Muzumdar D. Macular thickness - an early predictor of diabetic macular oedema. J Clin Diagn Res. 2022; 16(5): NC01–NC04.
- 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. Invest Ophthalmol Vis Sci. 2013; 54(5): 3378–3384.
- Eliwa TF, Hegazy OS, Mahmoud SS, et al. Choroidal thickness change in patients with diabetic macular edema. Ophthalmic Surg Lasers Imaging Retina. 2017; 48(12): 970–977.
- Adhi M, Brewer E, Waheed NK, et al. Analysis of morphological features and vascular layers of choroid in diabetic retinopathy using spectral-domain optical coherence tomography. JAMA Ophthalmol. 2013; 131(10): 1267–1274.
- Regatieri CV, Branchini L, Carmody J, et al. Choroidal thickness in patients with diabetic retinopathy analyzed by spectral-domain optical coherence tomography. Retina. 2012; 32(3): 563–568.
- Shen ZJ, Yang XF, Xu J, et al. Association of choroidal thickness with early stages of diabetic retinopathy in type 2 diabetes. Int J Ophthalmol. 2017; 10(4): 613–618.
- Temel E, Özcan G, Yanık Ö, et al. Choroidal structural alterations in diabetic patients in association with disease duration, HbA1c level, and presence of retinopathy. Int Ophthalmol. 2022; 42(12): 3661–3672.
- Querques G, Lattanzio R, Querques L, et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes. Invest Ophthalmol Vis Sci. 2012; 53(10): 6017–6024.
- Pires I, Santos AR, Nunes S, et al. Macular thickness measured by stratus optical coherence tomography in patients with diabetes type 2 and mild nonproliferative retinopathy without clinical evidence of macular edema. Ophthalmologica. 2013; 229(4): 181–186.
- Srinivasan S, Pritchard N, Sampson GP, et al. Retinal thickness profile of individuals with diabetes. Ophthalmic and Physiological Optics. 2015; 36(2): 158–166.
- Murugesan S, Jha K, Krishnagopal S, et al. Central macular thickness in diabetics without retinopathy. TNOA J Ophthalmic Sci Res. 2018; 56(3): 150–154.
- Shen ZJ, Yang XF, Xu J, et al. Association of choroidal thickness with early stages of diabetic retinopathy in type 2 diabetes. Int J Ophthalmol. 2017; 10(4): 613–618.
- Safi H, Safi S, Hafezi-Moghadam A, et al. Early detection of diabetic retinopathy. Surv Ophthalmol. 2018; 63(5): 601–608.
- Duker JS, Waheed NK, Goldman DR. Handbook of retinal OCT: optical coherence tomography. Elsevier, Amsterdam 2022.
- Torabi H, Saberi Isfeedvajani M, Ramezani M, et al. Choroidal thickness and hemoglobin a1c levels in patients with type 2 diabetes mellitus. J Ophthalmic Vis Res. 2019; 14(3): 285–290.
- Unsal E, Eltutar K, Zirtiloğlu S, et al. Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol. 2014; 8: 637–642.
- Abadia B, Suñen I, Calvo P, et al. Choroidal thickness measured using swept-source optical coherence tomography is reduced in patients with type 2 diabetes. PLoS One. 2018; 13(2): e0191977.
- Sahinoglu-Keskek N, Altan-Yaycioglu R, Canan H, et al. Influence of glycosylated hemoglobin on the choroidal thickness. Int Ophthalmol. 2018; 38(5): 1863–1869.
- Wang W, Liu S, Qiu Z, et al. Choroidal thickness in diabetes and diabetic retinopathy: a swept source OCT study. Invest Opthalmol Vis Sci. 2020; 61(4): 29.
- Ambiya V, Kumar A, Baranwal VK, et al. Change in subfoveal choroidal thickness in diabetes and in various grades of diabetic retinopathy. Int J Retina Vitreous. 2018; 4: 34.
- Fernández-Espinosa G, Orduna-Hospital E, Boned-Murillo A, et al. Choroidal and retinal thicknesses in type 2 diabetes mellitus with moderate diabetic retinopathy measured by swept source OCT. Biomedicines. 2022; 10(9): 2314.
- Lattanzio R, Brancato R, Pierro L, et al. Macular thickness measured by optical coherence tomography (OCT) in diabetic patients. Eur J Ophthalmol. 2018; 12(6): 482–487.