Choroidal Assessment in Patients with Type 2 Diabetes Mellitus and Non-Proliferative Diabetic Retinopathy by Swept-Source Ocular Coherence Tomography and Image Binarization.
Otilia ObadăAnca Delia PantalonGabriela Rusu-ZotaAnca HăisanSmaranda Ioana LupuşoruDorin ChiseliţăPublished in: Medicina (Kaunas, Lithuania) (2022)
Background and Objectives: The aim of this study was to evaluate choroidal structure and vascularity indices in patients with non-proliferative diabetic retinopathy (NPDR). Materials and Methods : Sixty-three eyes from sixty-three patients were evaluated: 21 from healthy subjects, 20 with diabetes mellitus (DM) and no diabetic retinopathy (DR), and 22 with DM and non-proliferative diabetic retinopathy without diabetic macular edema (DME). Each patient underwent ocular examination, macular swept-source ocular coherence tomography (SS-OCT) imaging, glycemic control, and systemic high blood pressure (HBP) evaluation. Subfoveal choroidal thickness (SF-CT) was manually assessed on a line scan. Line scan OCT images were exported to ImageJ program. The areas under a 1.5, 3 and 6 mm horizontal line centered on the fovea were assessed by converting the OCT images to binary images, and total choroidal area (TCA), luminal area (LA), stromal area (SA), LA:SA ratio, and choroidal vascularity index (CVI) were evaluated. SF-CT and choroidal parameters were compared between groups, and correlations with ocular and systemic factors were analyzed. Results : SF-CT, TCA, LA, and SA were similar between groups. CVIs were significantly different between groups for all three studied areas (CVI-1.5: 66.21% vs. 66.06% vs. 63.74%, p = 0.003; CVI-3: 65.88% vs. 66.46% vs. 63.79%, p = 0.008; CVI-6: 64.79% vs. 65.40% vs. 63.61%, p = 0.032). NPDR patients had significantly lower CVIs compared to DM patients ( p < 0.05). No association of choroidal parameters with glycemic control, DM duration and HBP was found significant ( p < 0.05). Conclusions : Choroidal assessment by SS-OCT and image binarization in healthy subjects, subjects with DM without DR, and subjects with DM and NPDR indicated that CVI changes were identifiable and significant in early DR. The lack of association with ocular and systemic factors suggest that CVIs are reliable assessment parameters of choroidal vascular structure.
Keyphrases
- optical coherence tomography
- diabetic retinopathy
- glycemic control
- optic nerve
- end stage renal disease
- type diabetes
- computed tomography
- blood pressure
- chronic kidney disease
- newly diagnosed
- ejection fraction
- prognostic factors
- blood glucose
- deep learning
- magnetic resonance imaging
- adipose tissue
- bone marrow
- machine learning
- patient reported outcomes
- dual energy
- contrast enhanced
- insulin resistance
- positron emission tomography
- drug induced
- case report
- photodynamic therapy
- convolutional neural network
- heart rate