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Related Concept Videos

Diabetic Retinopathy01:27

Diabetic Retinopathy

DefinitionDiabetic retinopathy is a microvascular complication of diabetes affecting the retinal blood vessels.Risk FactorsDiabetic retinopathy is present in almost all individuals with type 1 diabetes and more than 60% of those with type 2 diabetes after two decades of disease.The risk increases with poor glycemic control, hypertension, dyslipidemia, smoking, pregnancy, and puberty.Although cataracts and glaucoma are also more frequent in people with diabetes, retinopathy remains the leading...

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Three-Dimensional Choroidal Vessels Assessment in Diabetic Retinopathy.

Elham Sadeghi1,2, Katherine Du1, Oluwaseyi Ajayi1

  • 1Department of Ophthalmology, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, United States.

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|March 25, 2025
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Summary

Diabetic retinopathy (DR) eyes show reduced choroidal vasculature, including mean choroidal vessel diameter and vascularity index, compared to healthy eyes. These changes suggest microvascular alterations contributing to ischemia in DR and diabetic macular edema.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Diabetology

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss.
  • Understanding choroidal vascular changes in DR is crucial for disease management.
  • Novel imaging algorithms can provide detailed insights into ocular microvasculature.

Purpose of the Study:

  • To evaluate choroidal vasculature in eyes with diabetic retinopathy (DR) using a novel three-dimensional algorithm.
  • To quantify changes in choroidal vascularity and vessel diameter in DR patients.
  • To compare choroidal vascular parameters between DR and healthy eyes.

Main Methods:

  • Retrospective cross-sectional study of 73 eyes with DR and 27 healthy eyes.
  • Swept-source optical coherence tomography (PlexElite-9000) was used for imaging.
  • A novel 3D algorithm involving ResUNet segmentation and Phansalkar thresholding was applied to analyze choroidal vasculature, calculating mean choroidal vessel diameter (MChVD), choroidal thickness (ChT), and choroidal vascularity index (CVI).

Main Results:

  • Eyes with DR exhibited significantly reduced average MChVD (200.47 µm vs. 240.26 µm) and global CVI compared to healthy controls.
  • Reduced MChVD and CVI were observed in DR, particularly in the temporal and central sectors.
  • Proliferative DR showed decreased ChT in the temporal sector, while diabetic macular edema (DME) eyes had significantly reduced average CVI compared to non-DME eyes.

Conclusions:

  • Diabetic retinopathy and diabetic macular edema are associated with reduced mean choroidal vessel diameter and choroidal vascularity index.
  • These vascular changes in the choroid may be linked to microvascular alterations and ischemia in DR.
  • The findings suggest the potential of choroidal vascular parameters as novel biomarkers for understanding DR pathogenesis.