Choroidal Thickness in Different Patterns of Diabetic Macular Edema

Abstract

This observational study investigated the changes in choroidal thickness (ChT) in different patterns of diabetic macular edema (DME) based on image processing using enhanced-depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT). Participants with ocular conditions affecting the fundus view, including retinal diseases, were excluded. After observing the patient’s medical record, multicolor fundus photos, thickness maps, and subtypes of DME were diagnosed according to the criteria reported by the Early Treatment Diabetic Retinopathy Study (ETDRS). Edema was classified as focal or diffuse and was subdivided into cystic macular edema (CME), CME with subretinal fluid (CME+), and spongy macular edema (SME). Image processing was performed on the B-scan images from SD-OCT to segment the choroid layer and obtain the choroid thickness. A total of 159 eyes of 81 patients (46 males and 35 females; 57.53 ± 9.78 years of age), and 57 eyes of 30 healthy individuals (age 57.34 ± 8.76 years) were enrolled in this study. Out of 159 eyes, 76 had focal macular edema (FME), 13 exhibited SME, and 51 presented CME. Among those with cystic macular edema, 19 eyes showed subretinal fluid (CME+). The average choroidal thickness in FME, diffuse SME, CME, and CME+ was 216.95 ± 52.94 µm, 243.00 ± 46.34 µm, 221.38 ± 60.78 µm, and 249.63 ± 53.90 µm, respectively. The average choroidal thickness in age-matched controls was 213.88 ± 45.60 µm. Choroidal thickness increases with the severity of edema; choroidal thickness was higher in diffuse macular edema than in FME. However, choroidal thickness increased in cystic macular edema with subretinal fluid (CME+).

Production enhancement of human adipose-derived mesenchymal stem cells by low-intensity ultrasound stimulation

“…All statistical analysis were performed using the MATLAB software Version 2019a (MathWorks Corp., USA) 47 , 48 . Statistical values were expressed as mean, SD, and t-test values.…”

Prevalence of bacillary layer detachment in diabetic macular edema and response to 3 anti-vascular endothelial growth factor treatment

“…[33] Among eyes with DME, SRF eyes exhibited the thickest choroid. [33,34] High BALAD internal reflectivity and a high rate of suspended hyper-reflective particles likely indicate photoreceptor debris and inflammatory products. [26] These findings of hyper-reflective contents led to the hypothesis that the accumulation of said contents modulated the adhesion between photoreceptor outer segment and RPE, and induced BALAD formation in these areas when hydrostatic pressure was exerted by subretinal exudation.…”

Mechanisms of macular edema

“…Changes to the choroid are also likely to affect processes of retinal fluid absorption across the RPE cells. There are choroidal changes in diabetes, including choroidal vascular loss, choroidal neovascularization, and altered subfoveal choroidal thickness, which are reported to correlate with edema ( 82 , 83 ). There is conflicting data on the subfoveal thickness changes, which is discussed in a report by Lutty ( 84 ).…”