Choroidal Structural Changes Assessed with Swept-Source Optical Coherence Tomography after Cataract Surgery in Eyes with Diabetic Retinopathy

Abstract

Objective. To determine the influence of phacoemulsification on choroidal vasculature in patients with diabetic retinopathy (DR) undergoing cataract surgery using swept-source optical coherence tomography (SS-OCT). Methods. The study was conducted in 23 eyes of 23 cataract patients with mild/moderate nonproliferative diabetic retinopathy (NPDR) without diabetic macular edema (DME) and 23 age-matched controls. Choroidal thickness (CT) and choroidal vascularity index (CVI) were measured at baseline and 1 week, 1 month, and 3 months after surgery. Results. The baseline CVI in the DR group was significantly lower than that in the control group ( P = 0.001 ). CVI in DR patients after surgery significantly increased compared with preoperative values (all P < 0.001 for 1 week, 1 month, and 3 months after surgery). Postoperative increase of CVI and CT in the DR group was more than in the control group, and the difference was significant 1 month and 3 months after surgery (all P < 0.05 ). Conclusion. Patients with mild/moderate NPDR have reduced CVI compared with nondiabetic patients at baseline; diabetic cataract surgery tended to induce more increase in CVI and CT as compared with nondiabetic patients. This trial is registered with NCT04499768.

Analysis of the Choroid and Its Relationship with the Outer Retina in Patients with Diabetes Mellitus Using Binarization Techniques Based on Spectral-Domain Optical Coherence Tomography

“…In addition to providing nutrients to the retina, the choroid seems to play an important role in the development of DR. Hyadat et al reported in 1985 that in diabetic eyeschoriocapillaris, there is basement membrane thickening, capillary dropout and narrowing of the lumen and that choroidal arteries show arteriosclerotic changes [ 3 ]. These observations suggest that choroidal vasculopathy, further identified as diabetic choroidopathy (DC), might play an important role in the evolution of DR [ 3 , 4 ]. Fryczkowski et al identified, by scanning electron microscopy (SEM) studies, increased tortuosity, dilation and narrowing, hypercellularity, vascular loops and microaneurysms, “drop-out” of choriocapillaris and sinus-like structure formation between choroidal lobules [ 5 ].…”

Evaluation of structural and vascular changes in the choroid after uneventful phacoemulsification surgery

“…Yao et al evaluated CVI in patients with diabetic cataracts and reported a significant increase after surgery [ 1 ]. In contrast to an earlier study suggesting that changes in intraocular pressure after cataract surgery might lead to changes in choroidal thickness [ 20 ], Yao et al found no significant postoperative difference in intraocular pressure, despite a decrease [ 1 ].…”

“…Yao et al evaluated CVI in patients with diabetic cataracts and reported a significant increase after surgery [ 1 ]. In contrast to an earlier study suggesting that changes in intraocular pressure after cataract surgery might lead to changes in choroidal thickness [ 20 ], Yao et al found no significant postoperative difference in intraocular pressure, despite a decrease [ 1 ]. Similarly, in the current study, there was a decrease in intraocular pressure at the first and third postoperative month evaluations, but this was not statistically significant with respect to the measurement made before surgery.…”

“…Currently, phacoemulsification is one of the most preferred ophthalmologic surgery methods to increase visual acuity and among the most commonly performed intraocular operations in the treatment of cataracts [ 1 ]. The choroid is a tissue located between the sclera and retinal pigment epithelium, which has a vascular network rich in oxygenation and supplies the outer 1/ 3 of the retina with nutrition [ 2 ].…”

Choroidal Vascularity Index Fluctuations in Epiretinal Membranes in Vitreoretinal Surgery: Comparison Between Idiopathic and Diabetic Ones

“…The higher levels of proinflammatory cytokines and vascular endothelial growth factor in the choroid of patients with diabetic retinopathy may be one of the underlying mechanisms of the upregulating expression postoperatively, which is demonstrated to induce a higher increase in CVI in patients with mild to moderate nonproliferative diabetic retinopathy than in nondiabetic patients after cataract surgery. 30 …”