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ORIGINAL RESEARCH article

Front. Med.
Sec. Ophthalmology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1490831
This article is part of the Research Topic Imaging in the Diagnosis and Treatment of Eye Diseases View all articles

Regional assessment of choroidal vascularity index in patients with pre- and early-stage diabetic retinopathy using ultra-wide-field OCTA

Provisionally accepted
Yulei Chen Yulei Chen Haoxiong Xian Haoxiong Xian Minghui Liu Minghui Liu Xiuqing Dong Xiuqing Dong Shaolin Du Shaolin Du *
  • Department of Ophthalmology, Dongguan Tungwah Hospital, Dongguan, China

The final, formatted version of the article will be published soon.

    Purpose: To characterize the regional variations of choroidal vascularity index (CVI) in patients with diabetes mellitus (DM) using ultra-wide-field optical coherence tomography angiography (UWF-OCTA) and identify their correlations with the onset of diabetic retinopathy (DR). Methods: This cross-sectional, monocular-sampling study recruited 141 participants from four age-matched groups: no DM (NDM), no DR with early DM (EDM) and late DM (LDM), and mild-moderate non-proliferative diabetic retinopathy (mNPDR). UWF-OCTA was employed for circular scans centered on the fovea. CVI in the central region (0-1 mm) and 4 quadrants of the concentric rings with different ranges (1-3, 3-6, 6-9, 9-12, 12-15, 15-18 mm) was obtained for analysis together with their demographic and clinical data. The Area under the receiver operating characteristic curve (AUC) was calculated to assess the diagnostic efficacy for mNPDR and compared using the DeLong test. Results: The average CVI was lower in patients with mNPDR compared to other groups across all regions. Although there was no significant difference in DM duration between the LDM and mNPDR groups, a notable variance in CVI was observed, particularly (P = 0.0004) in the temporal quadrant of the 15-18 mm range (T18). CVI in T18 region was negatively correlated with creatinine levels, while positively correlated with body mass index and estimated glomerular filtration rate (Ps < 0.05). The CVI in the T18 region demonstrated superior diagnostic efficacy (AUC = 0.755), and when combined with those in other regions and clinical data, the AUC rose to 0.907, which was significantly better (P = 0.0280) than using clinical data alone. Conclusions: Reduced CVI was observed in the most peripheral region, highly predictive for mNPDR and associated with the declining renal function, thus enhancing the potential of UWF-OCTA to integrate into DM management and promote early DR screening.

    Keywords: Diabetes Mellitus, Diabetic Retinopathy, Optical coherence tomographic angiography, choroidal vascularity index, Renal function

    Received: 03 Sep 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Chen, Xian, Liu, Dong and Du. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Shaolin Du, Department of Ophthalmology, Dongguan Tungwah Hospital, Dongguan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.