Choroidal Thickness and Ganglion Cell Complex in Pubescent Children with Type 1 Diabetes without Diabetic Retinopathy Analyzed by Spectral Domain Optical Coherence Tomography

Gołębiewska, Joanna; Olechowski, Andrzej; Wysocka‐Mincewicz, Marta; Baszyńska-Wilk, Marta; Groszek, Artur; Czeszyk, Agnieszka; Szalecki, Mieczysław; Hautz, Wojciech

doi:10.1155/2018/5458015

Cited by 25 publications

(41 citation statements)

References 41 publications

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“…contains some general information about the studies reviewed in this article. Endo et al,Wang and Tao, Gupta et al,Rewbury et al, Ohara et al, Tan et al, Hua et al, Kim et al, Sudhalkar et al, Totan et al., Gerendas et al, Lee et al, Adhi et al, Regatieri et al, and Gołębiewska et al evaluated CT measurements and some of these studies also evaluated CVI in diabetic patients with and without DR as described inTable 2[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Kim et al only investigated for CVI in these patients[29].…”

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confidence: 99%

Choroidal Changes in Diabetic Patients With Different Stages of Diabetic Retinopathy

Hamadneh

Aftab

Sherali

et al. 2020

Cureus

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Diabetic retinopathy (DR) is one of the long-term microvascular complications of diabetes mellitus (DM) and is considered a leading cause of vision loss worldwide. Chronic hyperglycemia can cause microvascular abnormalities to the retina and the choroid as well. The vascular tissue of the choroid supplies blood to the outer retina, photoreceptors, and retinal pigment epithelium. It plays an important role in the metabolic exchange of the retina. Many experimental studies reported that choroidal pathology in diabetic patients might play a role in developing DR. Choroidal thickness (CT) can reflect changes in the vasculature of the choroid and can be used to assess the vascularity of the choroid itself. CT differs between healthy and diseased states of the eye as well as with the aging process. This means that thinner or thicker choroid may indicate an ocular disease. Choroidal vascularity index (CVI) is also used as a marker for choroidal vascularity assessment and indirectly measures choroidal vascularity quantitatively. Many studies have been conducted to evaluate the choroid in many different ocular diseases. However, the results regarding CT in DM, especially in patients with DR, are various as thickened, thinned, or no changes. Thus, the status of the choroid in patients with DM with or without DR remains controversial between researchers. In this systematic review, we reviewed 18 articles that were done to investigate the relationship between structural choroidal changes in diabetic patients with different stages of DR, focusing on CT, CVI, and some other parameters evaluating choroidal changes.

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confidence: 99%

Choroidal Changes in Diabetic Patients With Different Stages of Diabetic Retinopathy

Hamadneh

Aftab

Sherali

et al. 2020

Cureus

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“…Notably, Vujosevic et al 8 demonstrated a significant inverse correlation between perifoveal capillary loss in superficial capillary plexus (SCP) and inner retinal layer thickness in patients with DM and no clinical signs of DR. Since retinal thickness is decreased in pubescent T1DM children without DR and correlates with HbA1C level, some authors suggested that OCT can be considered a tool for early detection of retinal abnormalities in patients with diabetes 9 .…”

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confidence: 99%

Morphofunctional analysis of the retina in patients with type 1 diabetes without complications after 30 years of disease

Sacconi

Lamanna

Borrelli

et al. 2020

Sci Rep

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There is a lack of studies evaluating the sub-clinical retinal changes in patients with long-term type 1 diabetes mellitus (T1DM) and without history of systemic/ocular complications. The aim of this crosssectional study was to investigate sub-clinical structural and/or vascular retinal changes in patients with long-term (≥30 years) T1DM and without systemic/ocular complications ("happy few" patients) using structural optical coherence tomography (OCT), OCT-angiography and microperimetry. Twelve eyes of 12 consecutive T1DM patients (mean age 52 ± 12 years, mean duration of disease 35 ± 3 years, mean HbA1c level 7.3 ± 2.8%), without micro/macrovascular complications associated with long-standing T1DM, and twelve healthy subjects were consecutively included. No statistically significant differences were disclosed comparing patients and controls for age, sex, best-corrected visual acuity, central macular thickness, and choroidal thickness. Using OCT-angiography, we did not find any significant difference in foveal avascular zone area, perfusion density, vessel length density, and tortuosity. Moreover, no significant differences were disclosed in retinal nerve fiber layer and ganglion cell complex thickness using structural OCT. No differences were disclosed in retinal sensitivity by microperimetry. New diagnostic tools are able to confirm the presence of a particular population of patients with type 1 diabetes who have been completely spared from diabetic retinal complications. The finding of these "happy few" patients could help us to better understand and target future treatments for diabetes.Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and it develops in the majority of patients with long-standing type 1 diabetes mellitus (T1DM) 1 . For this reason, the American Diabetes Association (ADA) recommended a comprehensive ocular examination within 5 years after T1DM diagnosis in order to detect early signs of DR and to manage it promptly 2 . Retinal microaneurysms may represent the first visible clinical sign of DR and are secondary to small outpouchings of the retinal capillaries.Recently, new imaging technologies have enabled early identification of retinal structural and functional changes, even before DR is clinically evident. Optical coherence tomography angiography (OCT-A), a non-invasive dye-free imaging modality, provides a highly detailed view of the retinal and choroidal vasculature. Nowadays, optimized OCT-A algorithms may be used to detect early retinal and choriocapillaris (CC) microvascular flow alterations, which may be evident even before the DR presentation and may potentially result in irreversible retinal damage. As an example, De Carlo et al. 3 revealed OCT-A ability to detect foveal avascular zone (FAZ) remodeling and retinal capillary nonperfusion in T1DM patients without DR. Furthermore, both our group 4 and Simonett et al. 5 reported a significantly decreased perfusion density (PD) in the deep retinal vascular complex (DVC) in T1DM patients without evidence...

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“…There are conflicting reports on the effects of diabetes on PMCT. Previous studies on PMCT in adults suggested that the CT mainly increased at the early stage of diabetes and decreased at longer duration of diabetes (Vujosevic et al 2012;Tavares et al 2017;Horvath et al 2018;Tavares et al 2018;Golebiewska et al 2018). We supposed that the reason of conflicting of PMCT is mainly due to the difference of the duration.…”

Section: The Role Duration May Plays In the Posterior Pole Choroid Thmentioning

confidence: 69%

“…; Golebiewska et al. ). We supposed that the reason of conflicting of PMCT is mainly due to the difference of the duration.…”

Section: Discussionmentioning

confidence: 96%

“…Under consideration that the outside one third to half of the retina is nourished by the choroid, (Nickla & Wallman 2010) combined with the results of previous studies of increase in CT at the early stage of adults with diabetes and decrease in values at longer disease duration (Vujosevic et al 2012;Tavares et al 2017Tavares et al , 2018Golebiewska et al 2018;Horvath et al 2018). Our results suggested that the effects of diabetes on PPCT and PMCT during childhood varied according to the different regions: The temporal aspect of PMCT decreased, while that of other regions generally increased.…”

Section: The Change Trend Of Ct At the Posterior Pole In Children Witmentioning

confidence: 99%

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Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy

Jia

Wang

et al. 2019

Acta Ophthalmologica

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Purpose To study the characteristics of choroid thickness (CT) of the optic disc and macula in children with type 1 diabetes mellitus (T1DM) without visual impairment and diabetic retinopathy (DR) and analyse associated factors. Methods A square area of 6 × 6 mm around the centre of the optic disc and macula was scanned. The indices analysed mainly included CT at the macular centre (1 mm), and temporal, superior, nasal or inferior aspect of the inner ring (1–3 mm) and outer ring of (3–6 mm) optic disc and macula. Independent risk factors were analysed using multifactor linear regression. Results A total of 44 children with T1DM and 48 healthy subjects were enrolled. The diabetic group showed significant increase in the inferior inner ring of parapapillary CT (100.99 ± 30.42 μm versus 89.41 ± 34.00 μm, p = 0.04) and nasal outer ring of parapapillary CT (157.02 ± 47.35 μm versus 131.15 ± 35.17 μm, p = 0.01) as compared to those values in the healthy controls. Spherical equivalent refraction and family history of hypertension are independent factors of both peripappillary choroid thickness (PPCT) and macular choroid thickness (PMCT). Spherical equivalent refraction (p = 0.01) and serum cholesterol (p = 0.03) were independent factors of the inferior inner ring of parapapillary CT, whereas family history of hypertension was an independent factor of the nasal outer ring of parapapillary CT (p = 0.001). Conclusion In children with diabetes without DR or visual impairment, the CT increase in nasal outer ring of parapapillary (PPNO) and the inferior inner ring of parapapillary (PPII) may be the characteristic pre‐DR alteration at the early stage of DM. For children with higher serum cholesterol and family history of hypertension, the change of the nasal outer ring of parapapillary CT and the inferior inner ring of parapapillary CT may be more advanced.

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Choroidal Thickness and Ganglion Cell Complex in Pubescent Children with Type 1 Diabetes without Diabetic Retinopathy Analyzed by Spectral Domain Optical Coherence Tomography

Cited by 25 publications

References 41 publications

Choroidal Changes in Diabetic Patients With Different Stages of Diabetic Retinopathy

Choroidal Changes in Diabetic Patients With Different Stages of Diabetic Retinopathy

Morphofunctional analysis of the retina in patients with type 1 diabetes without complications after 30 years of disease

Change in peripapillary and macular choroidal thickness change in children with type 1 diabetes mellitus without visual impairment or diabetic retinopathy

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