Choroidal Assessment in Patients with Type 2 Diabetes Mellitus and Non-Proliferative Diabetic Retinopathy by Swept-Source Ocular Coherence Tomography and Image Binarization

Obadă, Otilia; Pantalon, Anca; Rusu-Zota, Gabriela; Haisan, Anca; Lupuşoru, Smaranda Ioana; Chiseliţă, D

doi:10.3390/medicina58070918

Cited by 6 publications

(1 citation statement)

References 56 publications

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“…Proliferative DR and DME have different retinal microvascular patterns that indicate small-vessel disease. When DME is present in proliferative DR, patients on oral anti hyperglycemic medications may be at an increase chance of developing cardiovascular disease [56] . Pan-retinal photocoagulation should be used to treat naive proliferative DR.…”

Section: Guideline Of Diabetic Macular Edema Managementmentioning

confidence: 99%

Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

Ngah¹,

Mohamed²,

Aziz³

et al. 2023

Int J Ophthalmol

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AIM: To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group’s efforts for diagnosis, treatment, and best practices of diabetic macular edema (DME). The experts’ panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula. The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load. METHODS: On two different occasions, a panel of 14 retinal specialists from Malaysia, together with an external expert, responded to a questionnaire on management of DME. A consensus was sought by voting after compiling, analyzing and discussion on first-phase replies on the round table discussion. A recommendation was deemed to have attained consensus when 12 out of the 14 panellists (85%) agreed with it. RESULTS: The terms target response, adequate response, nonresponse, and inadequate response were developed when the DME patients’ treatment responses were first characterized. The panelists reached agreement on a number of DME treatment-related issues, including the need to classify patients prior to treatment, first-line treatment options, the right time to switch between treatment modalities, and side effects associated with steroids. From this agreement, recommendations were derived and a treatment algorithm was created. CONCLUSION: A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.

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Section: Guideline Of Diabetic Macular Edema Managementmentioning

confidence: 99%

Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

Ngah¹,

Mohamed²,

Aziz³

et al. 2023

Int J Ophthalmol

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Choroidal vascularity index in health and systemic diseases: a systematic review

Motamed Shariati,

Khazaei,

Yaghoobi

2024

Int J Retin Vitr

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Background The choroid, a highly vascular structure within the eye, is significantly influenced by various systemic conditions. The advent of enhanced depth optical coherence tomography has improved our ability to evaluate choroidal pathophysiology. The choroidal vascularity index (CVI), a noninvasive and reliable tool, serves as an effective means of assessing the choroidal vascular structure. Recent studies have increasingly focused on exploring CVI alterations under different systemic conditions. This study aims to provide a comprehensive summary of the latest research findings in this area. Methods A systematic literature review was conducted on October 1, 2023, using two databases, MEDLINE (via PubMed) and Scopus. Search terms were tailored specifically for each database to ensure a thorough exploration of relevant literature. The studies identified were qualitatively assessed, with particular emphasis on outcomes related to CVI and choroidal thickness. Results A total of 48 studies were included in the review, encompassing a diverse range of systemic conditions such as diabetes, central nervous system disorders, cardiovascular diseases, autoimmune disorders, and infectious diseases. Notable reductions in CVI were observed in diabetic retinopathy, autoimmune diseases, and neurodegenerative disorders. Additionally, the review highlighted variations in CVI values related to the severity of systemic diseases, indicating its potential use as a biomarker for disease progression. Conclusion This review highlights the significant correlation between variations in the choroidal vascularity index and diverse systemic conditions affecting hemodynamics. An enhanced understanding of CVI provides deeper insights into the pathophysiological mechanisms underlying these disorders and positions CVI as a promising biomarker for early detection and monitoring. Nevertheless, its clinical utility warrants careful assessment. Future research should address the potential limitations of CVI to fully capitalize on its diagnostic and prognostic potential.

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Retinal and Choroidal Vascularization Parameters in Patients with Type 2 Diabetes Without Diabetic Retinopathy

Małyszczak,

Przeździecka-Dołyk,

Szydełko-Paśko

et al. 2024

OPTH

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Purpose The purpose of this study was to evaluate retinal and choroidal vascularization parameters in patients with type 2 diabetes mellitus (DM), without diabetic retinopathy (DR), and to compare them to healthy controls. Patients and methods Seventy-four eyes from 74 patients (40 eyes in the DM group and 34 eyes in the control group) were included in the study. Optical coherence tomography angiography RTVue XR Avanti was used to obtain 3×3mm scans of the macula. The choroidal vascularity index (CVI), superficial and deep capillary plexus vascular densities (SCP and DCP, respectively), and choroidal thickness (CT) were measured. Results In the diabetic group, SCP was lower in the superior and nasal segments (48.68 vs 50.62, p=0.02; 45.50 vs 48.82, p=0.02, respectively). The DCP did not differ between the groups. CVI was significantly lower in the study group in all measured segments, including central and parafoveal (31.73 vs 48.86 and 50.32 vs 59.58, p<0.001, respectively). CT was larger in the study group only at the center of the macula (281.89µm vs 268.37µm p<0.001) and in the inferior segment (337.47µm vs 329.40µm, p<0.001). In the multivariate regression, clinical and vascularization parameters affecting CVI and CT were analyzed after adjusting for age and sex. Decreased central CVI was associated with the presence of DM, lower central SCP, and bigger foveal avascular zone area (b=−0.68, b=0.47, b=−0.21). Parafoveal CVI was also negatively affected by DM (b= −0.46) and positively by parafoveal SCP (b= 0.44). Increased central CT was found to be positively associated with higher central SCP (b=0.48) and male sex (b=0.20). Conclusion The results of our study confirmed a reduction of SCP and CVI in diabetic patients without DR. DM and SCP are age and sex independent parameters affecting CVI. Central CT is affected by SCP and sex, rather than the presence of diabetes.

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Choroidal Assessment in Patients with Type 2 Diabetes Mellitus and Non-Proliferative Diabetic Retinopathy by Swept-Source Ocular Coherence Tomography and Image Binarization

Cited by 6 publications

References 56 publications

Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

Guidelines from an expert panel for the management of diabetic macular edema in the Malaysian population

Choroidal vascularity index in health and systemic diseases: a systematic review

Retinal and Choroidal Vascularization Parameters in Patients with Type 2 Diabetes Without Diabetic Retinopathy

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