Department of Endocrinology and Metabolic Diseases, Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Bolu, Turkey.
Department of Ophthalmology, Izzet Baysal Training and Research Hospital, Abant Izzet Baysal University, Bolu, Turkey.
J Endocrinol Invest. 2024 May;47(5):1175-1180. doi: 10.1007/s40618-023-02236-8. Epub 2023 Nov 22.
Today, limited and controversial data are available on predictive markers for diabetic retinopathy. Choroidal thickness (CT) is an unstable parameter affected by many factors. Also, previous studies had conflicting findings on choroidal thickness. In this study, we aimed to investigate the role of choroidal vascularity index (CVI), a relatively new marker, in evaluating choroidal vascular status and its relationship with diabetic retinopathy (DR).
A total of 124 subjects, 84 patients with type 2 diabetes mellitus (DM) and 40 healthy controls, were included in the study. The patients were divided into two groups as follows: those without DR and those with non-proliferative DR (NPDRP). All subjects underwent enhanced-depth imaging optical coherence tomography (EDI-OCT), and CT values were noted. To measure CVI, luminal (LA) and stromal areas of the choroidal images were binarized using Image J program. CVI was defined as the proportion of LA to total choroid area (TCA). Demographic and laboratory data of the patients were collected retrospectively.
CVI were found to be lower in diabetic patients compared to non-diabetic patients. CVI values in 3 groups were as follows: 67.9% ± 1.8 (healthy controls), 66.1% ± 2.4 (no DR), and 63.2% ± 2.6 (NPDRP) (p < 0.001). All groups were similar in terms of CT values (p = 0.296). The cut-off value for CVI in predicting retinopathy was 64.7%. Hypertension and current smoking were found to be more frequent in diabetic patients with CVI < 64.7% compared to those with CVI > 64.7%.
CVI tends to be lower in diabetic patients with or without DR compared to healthy controls. Moreover, patients with DR have a lower CVI than those without DR. CVI can be considered an early and sensitive biomarker for the onset of DR.
目前，关于糖尿病视网膜病变的预测标志物的相关数据有限且存在争议。脉络膜厚度（CT）是一个受多种因素影响的不稳定参数。此外，先前的研究对脉络膜厚度的研究结果存在差异。在这项研究中，我们旨在探讨相对较新的标志物脉络膜血管指数（CVI）在评估脉络膜血管状态及其与糖尿病视网膜病变（DR）的关系中的作用。
共纳入 124 名受试者，84 名 2 型糖尿病患者和 40 名健康对照者。患者分为无 DR 组和非增生性 DR 组（NPDRP）。所有受试者均行增强深度成像光学相干断层扫描（EDI-OCT），并记录 CT 值。使用 Image J 程序对脉络膜图像的管腔（LA）和基质区域进行二值化，以测量 CVI。CVI 定义为 LA 与总脉络膜面积（TCA）的比例。回顾性收集患者的人口统计学和实验室数据。
与非糖尿病患者相比，糖尿病患者的 CVI 较低。3 组的 CVI 值如下：健康对照组为 67.9%±1.8，无 DR 组为 66.1%±2.4，NPDRP 组为 63.2%±2.6（p<0.001）。各组 CT 值无差异（p=0.296）。预测视网膜病变的 CVI 截断值为 64.7%。与 CVI>64.7%的糖尿病患者相比，CVI<64.7%的糖尿病患者更易出现高血压和当前吸烟。
与健康对照组相比，无论是否存在 DR，糖尿病患者的 CVI 均较低。此外，DR 患者的 CVI 低于无 DR 患者。CVI 可作为 DR 发病的早期、敏感的生物标志物。
