Journal List > J Korean Ophthalmol Soc > v.56(12) > 1010166

Lee and Kim: Choroidal Thickness at the Outside of Fovea in Diabetic Retinopathy Using Spectral-Domain Optical Coherence Tomography

Abstract

Purpose

To evaluate choroidal thickness at the outside of the fovea in patients with diabetic retinopathy using spectral-domain optical coherence tomography.

Methods

We examined 87 eyes of 87 patients with diabetic retinopathy and 40 eyes of 40 normal patients. Patients with diabetic retinopathy were divided into 3 groups according to the grade of diabetic retinopathy and macular edema. The choroidal thick-ness was obtained at the fovea and outside of the fovea using enhanced depth imaging of Spectralis optical coherence tomography. One foveal and 8 peripheral images were selected and choroidal thickness was measured from the outer border of the retinal pigment epithelium to the inner scleral border.

Results

Subfoveal choroidal thickness was thinner with increasing severity of diabetic retinopathy. However, there was no sig-nificant difference between groups without the nasal side of the fovea. A statistically significant difference was observed over the fovea at the superotemporal area.

Conclusions

The choroidal thickness outside of the fovea was thinner with the severity of diabetic retinopathy and was more pro-nounced in the superotemporal area.

References

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Figure 1.
The study model about choroidal thickness of the fovea and posterior perivascular area. Choroidal thickness was measured at not only the fovea but also the superior, inferior, superonasal, inferonasal area from the fovea.
jkos-56-1893f1.tif
Figure 2.
Graph of the average choroidal thickness under the fo-vea in normal subjects and patients with diabetic retinopathy (T1-4: 0.5/1.0/1.5/2.0 mm temporally apart from the fovea; N1-4: 0.5/1.0/1.5/2.0 mm nasally apart from the fovea). F = fo-vea; NPDR = nonproliferative diabetic retinopathy; DME = di-abetic macular edema; PDR = proliferative diabetic retinopathy.
jkos-56-1893f2.tif
Table 1.
Characteristics of normal subjects and patients with diabetic retinopathy
Normal NPDR/ME- NPDR/ME+ PDR
Number (male/female) 40 (22/18) 18 (12/6) 44 (21/23) 25 (12/13)
Age (years) 59 60 62 63
Arterial hypertension NA 7 (39%) 19 (43%) 12 (48%)
Use of insulin NA 3 (17%) 9 (20%) 6 (24%)

NPDR = nonproliferative diabetic retinopathy; ME = macular edema; PDR = proliferative diabetic retinopathy; NA = not applicable.

Table 2.
Choroidal thickness of under the fovea in normal subjects and patients with diabetic retinopathy
Choroidal thickness (μ m)
p-value*
Control C NPDR/ME- horoidal thickness (μ m) NPDR/ME+ PDR All
T4 251.83 ± 99.79 248.11 ± 101.27 225.25 ± 112.95 186.28 ± 82.59 229.19 ± 103.46 0.074
T3 273.75 ± 102.50 255.44 ± 107.99 243.82 ± 113.43 202.24 ± 85.95 246.71 ± 106.12 0.066
T2 295.10 ± 112.90 280.89 ± 123.99 255.48 ± 117.55 217.64 ± 88.69 264.11 ± 114.16 0.050
T1 302.58 ± 114.33 273.94 ± 111.83 264.34 ± 118.04 231.84 ± 90.16 271.35 ± 112.58 0.095
F 309.25 ± 110.72 280.94 ± 113.64 266.05 ± 117.10 239.72 ± 88.69 276.58 ± 111.20 0.083
N1 306.70 ± 105.87 289.11 ± 123.06 260.50 ± 112.55 241.36 ± 76.65 275.34 ± 107.70 0.070
N2 303.10 ± 102.88 283.39 ± 131.16 248.55 ± 110.45 234.64 ± 65.51 267.93 ± 106.57 0.033
N3 293.33 ± 96.90 273.72 ± 116.17 235.75 ± 109.31 221.96 ± 64.71 256.55 ± 102.29 0.014
N4 277.33 ± 90.84 255.67 ± 99.83 223.11 ± 105.01 205.04 ± 76.15 241.24 ± 97.90 0.012

Values are presented as mean ± SD unless otherwise indicated. T1-4 is 0.5/1.0/1.5/2.0 mm temporally apart from the fovea, and N1-4 is 0.5/1.0/1.5/2.0 mm nasally apart from the fovea. NPDR = nonproliferative diabetic retinopathy; ME = macular edema; PDR = proliferative diabetic retinopathy; F = fovea.* p-value represent the results of posttest comparison on with Tukey multiple test (N3: p = 0.044; N4: p = 0.048 in NPDR/ME vs. PDR group).

Table 3.
Choroidal thickness of the fovea and the posterior perivascular area
Normal NPDR/ME- NPDR/ME+ PDR p-value*
Superior (far, μ m) 266.19 ± 50.90 237.45 ± 55.31 230.89 ± 64.40 213.10 ± 69.07 0.005
Superior (near, μ m) 294.62 ± 75.60 268.45 ± 79.22 249.52 ± 86.38 233.32 ± 71.39 0.013
Center (μ m) 290.33 ± 96.90 271.25 ± 105.23 246.98 ± 103.22 220.08 ± 70.54 0.028
Inferior (near, μ m) 243.38 ± 82.51 232.41 ± 80.84 213.76 ± 88.44 212.60 ± 86.22 0.353
Inferior (far, μ m) 200.45 ± 69.36 181.30 ± 52.40 172.26 ± 56.33 161.50 ± 77.79 0.089
Superonasal (far, μ m) 221.80 ± 58.36 190.28 ± 61.83 198.13 ± 58.49 194.41 ± 66.91 0.151
Superonasal (near, μ m) 210.25 ± 66.93 194.39 ± 63.88 198.66 ± 66.65 174.50 ± 67.35 0.217
Inferonasal (near, μ m) 182.29 ± 63.97 164.22 ± 64.64 167.56 ± 66.69 147.96 ± 65.95 0.235
Inferonasal (far, μ m) 155.29 ± 48.00 141.96 ± 51.38 142.56 ± 45.30 142.28 ± 44.32 0.556

Values are presented as mean ± SD unless otherwise indicated. Comparison of choroidal thickness of the fovea and outside of the fovea. Choroidal thickness was calculated by an average of 9 points in each line. NPDR = nonproliferative diabetic retinopathy; ME = macular edema; PDR = proliferative diabetic retinopathy.* p-value represent the results of posttest comparison on with Tukey multiple test. Tukey multiple test: Center; PDR vs. normal ( p = 0.024), superior (near); NPDR/ME+ vs. normal ( p = 0.05), PDR vs. normal ( p = 0.015), superior (far); NPDR/ME+ vs. normal ( p = 0.041), PDR vs. normal ( p = 0.004).

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