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Region-specific choroidal vascular alterations in diabetes revealed by ultra-wide-field swept-source OCTA
Siyu Yang1, Yi Zhang1, Ruibing Sun1
1Department of Ophthalmology, The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, 518107, China.
Purpose:
To compare choroidal vascular alterations using ultra-wide-field swept-source optical coherence tomography angiography (UWF-SS-OCTA) between diabetic eyes and control eyes, and to evaluate their associated factors and diagnostic relevance.
Methods:
UWF-SS-OCTA (24 × 20 mm) was performed in non-diabetic controls (NDM), diabetic patients without retinopathy (NDR), and patients with non-proliferative diabetic retinopathy (NPDR). The scan area was divided into nine regions. Choroidal vascularity index (CVI), choroidal vascular volume per unit area (CVV/a), choroidal stromal volume per unit area (CSV/a), and choroidal stromal index (CSI) were compared among groups. Associations with clinical variables were analysed, and diagnostic performance was assessed using receiver operating characteristic analysis.
Results:
Mean CVI was significantly reduced in diabetic eyes, including NDR, compared with controls. The nasal-superior region showed the most pronounced reductions in CVI, CVV/a, and CSV/a. These parameters were negatively associated with age and independently influenced by diabetic status. CVI and CVV/a demonstrated good discrimination between diabetic and non-diabetic eyes but did not distinguish NDR from NPDR.
Conclusion:
Region-specific choroidal vascular impairment occurs early in diabetes. Nasal-superior CVI and CVV/a may serve as non-invasive biomarkers of early diabetic choroidopathy.
