Relationship Between Renal Function and Choroidal Thickness in Type 2 Diabetic Patients Detected by Swept-Source Optical Coherence Tomography

Liu, Sen; Wang, Wei; Tan, Yan Zhi; He, Miao; Wang, Lanhua; Li, Yuting; Huang, Wenyong

doi:10.1167/tvst.9.5.17

Cited by 10 publications

(6 citation statements)

References 35 publications

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“…The influence of renal function on ChT was confirmed in a wider population of hypertensive non-diabetic individuals, including patients with renal disease unrelated to high BP, where albuminuria and eGFR were found to be inversely and directly related to ChT, respectively [ 69 ]. Similar results come from a total of 1395 ocular treatment-naïve Chinese patients with type 2 diabetes, where ChT decreased in parallel with renal impairment [ 72 ]. Moreover, in a population of 150 individuals (50 with hypertension, 50 with CKD, and 50 healthy controls), a direct association between eGFR and ChT was reported, with evidence that a thinner choroid was associated with increased serum levels of well-known biochemical markers of oxidative stress, inflammation, and endothelial dysfunction, namely asymmetric dimethylarginine, C-reactive protein, IL-6, and endothelin-1 [ 70 ].…”

Section: Retinal and Glomerular Vasculature: Two Sides Of The Same Coinsupporting

confidence: 59%

Arterial Hypertension and the Hidden Disease of the Eye: Diagnostic Tools and Therapeutic Strategies

et al. 2022

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Hypertension is a major cardiovascular risk factor that is responsible for a heavy burden of morbidity and mortality worldwide. A critical aspect of cardiovascular risk estimation in hypertensive patients depends on the assessment of hypertension-mediated organ damage (HMOD), namely the generalized structural and functional changes in major organs induced by persistently elevated blood pressure values. The vasculature of the eye shares several common structural, functional, and embryological features with that of the heart, brain, and kidney. Since retinal microcirculation offers the unique advantage of being directly accessible to non-invasive and relatively simple investigation tools, there has been considerable interest in the development and modernization of techniques that allow the assessment of the retinal vessels’ structural and functional features in health and disease. With the advent of artificial intelligence and the application of sophisticated physics technologies to human sciences, consistent steps forward have been made in the study of the ocular fundus as a privileged site for diagnostic and prognostic assessment of diverse disease conditions. In this narrative review, we will recapitulate the main ocular imaging techniques that are currently relevant from a clinical and/or research standpoint, with reference to their pathophysiological basis and their possible diagnostic and prognostic relevance. A possible non pharmacological approach to prevent the onset and progression of retinopathy in the presence of hypertension and related cardiovascular risk factors and diseases will also be discussed.

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Section: Retinal and Glomerular Vasculature: Two Sides Of The Same Coinsupporting

confidence: 59%

Arterial Hypertension and the Hidden Disease of the Eye: Diagnostic Tools and Therapeutic Strategies

et al. 2022

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“…We have shown in previous studies using spectral domain OCT and SS-OCT that both retina and choroidal layers presented decreased thickness in early stages of DR (no or mild DR), especially in patients with some degree of kidney damage 15 28. According to Liu et al , conflicting results about CT in diabetic eyes can be explained by different protocol designs, patient profiles, adjustment for confounding factors and different devices 29…”

Section: Discussionmentioning

confidence: 97%

“…15 28 According to Liu et al, conflicting results about CT in diabetic eyes can be explained by different protocol designs, patient profiles, adjustment for confounding factors and different devices. 29 The strength of our study is the use of SS-OCT technology, which enables more precise identification of the choroidal-scleral edge and, consequently, more reliable CT and CC density measurements. The main limitations are its cross-sectional design, relatively small sample and limiting sample factors such as the high prevalence of white women and not age-matched controls.…”

Section: Discussionmentioning

confidence: 97%

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Early choroidal changes detected by swept-source OCT in type 2 diabetes and their association with diabetic kidney disease

Silva

Chaves

Gobbato

et al. 2022

BMJ Open Diab Res Care

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IntroductionMicrovascular changes in eye and kidney shares some common factors in diabetes mellitus (DM). The purpose was to evaluate choroidal thickness (CT) and choriocapillaris (CC) density in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) using swept-source optical coherence tomography (SS-OCT).Research design and methodsA cross-sectional study was conducted with patients with T2D with mild or no diabetic retinopathy (DR) and non-diabetic controls. CT was measured with SS-OCT, and CC vascular density was measured with OCT angiography. These parameters were compared with inner retinal layers thickness in patients with and without DKD and non-diabetic controls.ResultsNinety-three eyes from patients with T2D and 34 eyes from controls volunteers were included. Within the T2D group, 56 eyes with DKD and 37 eyes from patients with no diabetic kidney disease were examined. A statistically significant reduction of CT was observed in patients with DKD compared with controls, with no difference in CC density. There was an association between ganglion cell layer and central choroidal thickness reduction in the DKD group.ConclusionsPatients with T2D with DKD showed a decrease in CT with no difference in CC density compared with non-diabetic controls. This thinning might be related to vascular changes of choroidal layers such as Haller’s and Sattler’s with preservation of CC density, which is crucial for outer retina and retinal pigment epithelium health. Longitudinal studies are warranted to determine the association of choroidal changes with the pathogenesis of diabetes, and its association with early DKD and progression to more severe DR.

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“…In our sample we found a signi cant trend of thinning in choroid of T2D patients, also observed in nDKD group. Liu et al (2020) suggested that these con icting results could be explained by different protocol designs, patient pro les, adjustment for confounding factors, and different protocol devices [29].…”

Section: Discussionmentioning

confidence: 99%

Early Choroidal and Retinal Changes Detected by Swept-Source Oct in Type 2 Diabetes and Their Association with Diabetic Kidney Disease: A Longitudinal Prospective Study

Silva

Chaves

Gobbato

et al. 2023

Preprint

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Background To evaluate structural changes in retina and choroid in patients with type 2 diabetes (T2D) and their association with diabetic kidney disease (DKD) Methods T2D patients with mild or no diabetic retinopathy (DR) were followed for 3 years using structural SS-OCT and OCT angiography (OCT-A) taken every 6 months. Parameters were compared longitudinally and according to the DKD status on baseline. Results One hundred and sixty eyes from 80 patients were followed for 3 years, 72 with no DKD (nDKD) at baseline and 88 with DKD. Trend analysis of T2D showed significant thinning in GCL + and circumpapillary retinal fiber neural layer (cRFNL), choroid, and decreased vascular density (VD) in superficial plexus and central choriocapillaris with foveal avascular zone (FAZ) enlargement. Patients with no DKD on baseline presented more significant declines in retinal center and choroidal thickness, increased FAZ and loss of nasal and temporal choriocapillaris volume. In addition, the nDKD group had worse glycemic control and renal parameters at the end of the study. Conclusion Our data suggest that early, progressive neurovascular damage occurs in the retina and choroid in T2D patients with no or mild DR. Glycemic control and renal damage parameters were associated to neurovascular damage progression.

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Relationship Between Renal Function and Choroidal Thickness in Type 2 Diabetic Patients Detected by Swept-Source Optical Coherence Tomography

Abstract: Relationship between renal function and choroidal thickness in type 2 diabetic patients detected by swept-source optical coherence tomography.

Cited by 10 publications

References 35 publications

Arterial Hypertension and the Hidden Disease of the Eye: Diagnostic Tools and Therapeutic Strategies

Arterial Hypertension and the Hidden Disease of the Eye: Diagnostic Tools and Therapeutic Strategies

Early choroidal changes detected by swept-source OCT in type 2 diabetes and their association with diabetic kidney disease

Early Choroidal and Retinal Changes Detected by Swept-Source Oct in Type 2 Diabetes and Their Association with Diabetic Kidney Disease: A Longitudinal Prospective Study

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