Choroidal changes and associations with visual acuity in diabetic patients

Area of Science:

• Ophthalmology
• Diabetology
• Medical Imaging

Background:

• The current staging system for diabetic retinopathy (DR) inadequately explains variable visual function.
• Choroidal changes are increasingly recognized as significant in DR progression and visual outcomes.

Purpose of the Study:

• To evaluate choroidal changes in standardized sectors of DR patients.
• To identify associations between choroidal measurements and visual function in DR.

Main Methods:

• A cross-sectional study involving 265 diabetic patients with DR and 73 age-matched controls.
• Enhanced depth imaging Optical Coherence Tomography (OCT) was used to assess the choroid.
• Choroidal Vascularity Index (CVI) was calculated in a 5mm foveal scan.

Main Results:

• Choroidal Vascularity Index (CVI) decreased with age and was significantly lower in DR eyes with prior treatments compared to controls and treatment-naïve DR eyes.
• No significant difference in CVI was found between non-DR diabetic patients and normal controls.
• In treated DR patients, CVI correlated negatively with best-corrected visual acuity (BCVA), while retinal thickness did not.

Conclusions:

• A reduced CVI is associated with more advanced stages of diabetic retinopathy.
• Choroidal biomarkers, specifically CVI, correlate with visual acuity in treated DR patients with stable disease, suggesting their potential as prognostic indicators.