Choroidal thickness changes in non-treated eyes of patients with diabetes: swept-source optical coherence tomography study

• Published in: Acta diabetologica Vol. 55; no. 9; pp. 927 - 934
• Main Authors: Horváth, Hajnalka, Kovács, Illés, Sándor, Gábor László, Czakó, Cecília, Mallár, Klaudia, Récsán, Zsuzsanna, Somogyi, Anikó, Nagy, Zoltán Zsolt, Ecsedy, Mónika
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01-09-2018; Springer Nature B.V
• Subjects: Adult; Aged; Case-Control Studies; Choroid - diagnostic imaging; Choroid - pathology; Cross-Sectional Studies; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - pathology; Diabetic retinopathy; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - etiology; Diabetic Retinopathy - pathology; Eye; Female; Glycated Hemoglobin A - metabolism; Hemoglobin; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Organ Size; Original Article; Patients; Regression analysis; Retinopathy; Severity of Illness Index; Tomography; Tomography, Optical Coherence - methods; Diabetic retinopathy; Choroidal thickness; Swept-source optical coherence tomography; Diabetic choroidopathy
• ISSN: 0940-5429; 1432-5233
• DOI: 10.1007/s00592-018-1169-0

Aims
To measure choroidal thickness (CT) in diabetic eyes and its correlation with metabolic status and the severity of diabetic retinopathy (DR).
Materials and methods
Prospective cross-sectional study using swept-source optical coherence tomography. CT maps of 96 treatment naïve eyes of 48 patients with diabetes were compared to 46 eyes of 23 healthy controls. CT changes and their relation to diabetes, age, gender, disease duration, hypertension (HT), hemoglobin A1c level, type and severity of DR were evaluated.
Results
A significantly thinner choroid was measured in patients with diabetes compared to controls (
p
 < 0.009). In the diabetic group age, gender, disease duration and HT were significantly correlated with CT in univariable regression models (
p
 < 0.05). In multivariable analysis, the duration of diabetes significantly negatively correlated with CT (
p
 = 0.02). According to analysis of variance, there was a significant difference among means of CT in different stages of DR (
p
 = 0.002), with thinner CT in cases with more advanced DR. In a multivariable predictive model, thinner CT was associated with an increased risk for the presence of DR (
p
 = 0.02).
Conclusions
Diabetes mellitus itself and the severity of DR affect CT significantly, even after adjusting for the effects of confounding systemic factors. Disease duration seems to be associated with a reduction of choroidal thickness. Decreased CT proved to be correlated with the severity of DR.