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Decrease in Choroidal Vascularity Index of Haller's layer in diabetic eyes precedes retinopathy.

Valencia Hui Xian Foo1,2, Preeti Gupta2, Quang Duc Nguyen2

  • 1Singapore National Eye Centre, Singapore.

BMJ Open Diabetes Research & Care
|September 11, 2020
PubMed
Summary

Diabetic eyes show reduced Choroidal Vascularity Index (CVI) in Haller's layer, even without retinopathy. Longer diabetes duration further decreases Sattler's layer CVI and choroidal volume.

Keywords:
A1Cacute and late complicationspathophysiological processesretinopathy

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Area of Science:

  • Ophthalmology
  • Diabetology
  • Medical Imaging

Background:

  • Diabetic retinopathy (DR) is a major complication of diabetes, affecting the choroidal vasculature.
  • Choroidal Vascularity Index (CVI) is a novel imaging biomarker derived from optical coherence tomography (OCT) scans.

Purpose of the Study:

  • To evaluate the Choroidal Vascularity Index (CVI) of Haller's and Sattler's layers in patients with and without diabetes, and its relationship with diabetic retinopathy.
  • To assess choroidal and retinal thickness and volumes using enhanced depth imaging-OCT.

Main Methods:

  • Retrospective analysis of 165 eyes from the Singapore Indian Eye Study-2.
  • Participants were categorized into three groups: no diabetes, diabetes without DR, and diabetes with DR.
  • Enhanced depth imaging-OCT scans were used to measure CVI, choroidal thickness, and volume.

Main Results:

  • Eyes with diabetes but no DR showed significantly reduced macular CVI of Haller's layer compared to non-diabetic eyes.
  • Longer diabetes duration (>5 years) was associated with significantly decreased CVI of Sattler's layer and subfoveal choroidal volume.
  • Early diabetic choroidopathy appears to affect larger choroidal veins initially.

Conclusions:

  • Reduced macular Haller's layer CVI in diabetic eyes without DR suggests early vascular changes.
  • CVI of Haller's layer may serve as an early marker for DR onset in newly diagnosed diabetic patients.
  • Further research is needed to establish the prognostic value of CVIs for visual acuity and photoreceptor health.