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

Seong Woo Lee; Jae Suk Kim

doi:10.3341/jkos.2015.56.12.1893

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

Original Article

J Korean Ophthalmol Soc 2015;56(12):1893-1898.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.12.1893

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

Seong Woo Lee, M.D, Jae Suk Kim, M.D

Department of Ophthalmology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea

Address reprint requests to Jae Suk Kim, MD Department of Ophthalmology, Sanggye Paik Hospital, #1342 Dongil-ro, Nowon-gu, Seoul 01757, Korea Tel: 82-2-950-1096, Fax: 82-2-935-6904 E-mail: 991027js@hanmail.net

Received 12 June 201521 July 2015 Accepted 22 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Choroidal thickness, Diabetic retinopathy, Enhanced depth imaging, Optical coherence tomography

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.

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.

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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