Choroidal Thickness and Hemoglobin A1c Levels in Patients with Type 2 Diabetes Mellitus

Abstract

PurposeThe aim of this study was to assess the correlation of hemoglobin A1c (HbA1c) levels with choroidal thickness in patients with type 2 diabetes mellitus (DM) using spectral domain optical coherence tomography (SD-OCT).MethodsIn this prospective case series, 180 eyes from 90 patients with type 2 DM were classified into three study groups based on HbA1c values: group 1 included patients with good glycemic control (HbA1c ≤ 7%), group 2 included patients with moderate glycemic control (HbA1c between 7% and 8%), and group 3 included patients with poor glycemic control (HbA1c ≥ 8%). Additionally, 50 eyes from 25 non-diabetic subjects were enrolled to group 4 as a control group. Sub-foveal, nasal, and temporal choroidal thickness were measured and compared.ResultsMean central, nasal, and temporal choroidal thicknesses in diabetic patients (247.80, 238.63, and 239.30 μm) were significantly less than non-diabetic healthy subjects (277.56, 262.92, and 266.32 μm). Additionally, mean central, nasal, and temporal choroidal thickness values in group 4 (277.56, 262.92, and 266.32 μm) were significantly greater than the corresponding values in group 2 (248.34, 237.55, and 236.45 μm) and group 3 (239.81, 234.62, and 233.94 μm), but was not significantly different from corresponding values in group 1 (259.46, 246.12, and 251.00 μm).Conclusion HbA1c values have a significant correlation with choroidal thickness in diabetic patients, and better glycemic control with HbA1c ≤ 7% may prevent choroidal thinning.

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

“…Duration of diabetes was 10.31 ± 8.27 years in the NDR group and 14.65 ± 6.22 years in the DR group ( p = 0.002), but it did not correlate with FChT or CVI. This observation is in agreement with other reports, such as Torabi et al [ 31 ], but in contradiction with Hiroaki et al [ 32 ] or Niestrata-Ortiz et al [ 33 ], who observed choroidal changes occurring before the development of DR and progression with increasing duration of DM despite the absence of any DR or increased retinal thickness. As Tan et al reported, the duration and control of DM can lead to potentially confounded choroidal thickness measurements [ 14 ].…”

“…We have compared HbA1C values between groups, thinking that poor diabetic control with permanent high blood sugar levels could induce choroidal vascular damage, as previous studies reported [ 31 , 34 ]. We found no significant difference between NDR and DR groups concerning HbA1C values.…”

“…Surprisingly, mean values for ONL, IS + OS and PR layers were increased in DR versus NDR. Earlier studies found a strong connection between choriocapillaris perfusion and photoreceptor health measured by ellipsoid zone reflectivity in NPDR [ 24 ], emphasizing the dependence of the outer retinal layers on the choroid for nutrition and oxygenation [ 31 ]. The decrease in the PR layer thickness in our series, as Gella et al also found [ 42 ], could be explained by the increased superoxide and soluble inflammatory factors produced by the PR cells themselves in response to the potentially damaging elevated glucose environment [ 43 ].…”

Evaluation of the Effect of Type 1 and Type 2 Diabetes Mellitus without Diabetic Retinopathy on Subfoveal Choroidal Thickness and Central Macular Thickness in Adolescents

“…Since our study consists of pediatric type 2 DM patients, the duration of diabetes follow-up is approximately 4 years and this value is within the first 77 months of the study of Tavares Ferreria et al In addition, they reported that choroidal thickness was not associated with diabetes duration, blood glucose level, HbA1c, and mean arterial pressure [21]. Unlike our study Torabi H et al showed that the HbA1c level correlated with choroidal thickness in adults with type 2 DM patients and stated that as the HbA1c level increased, the choroidal thickness decreased [22]. Similar to our study, Ambiya V et al could not see a significant difference between the choroidal thickness of DM patients without retinopathy and the control group [23].…”

Multimodal Retinal Imaging for Detection of Ischemic Stroke

“…The examination process is non-invasive, rapid, and highly reproducible, with promising clinical application. Choroid thickness has proven to be important in the diagnosis of various ophthalmologic and systemic diseases (Tan et al, 2016 ; Obis et al, 2018 ; Steiner et al, 2019 ; Torabi et al, 2019 ). Currently, the relationship between choroid thickness and disease is a research hotspot.…”