Research progress of choroidal vascular index in diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Wang Xiaokun ^1,2 , Wu Chao ^1,2 , Cui Yanyan ³ , Chang Weiwei ⁴ ,  Zhao Bojun ^1,2

1. Cheeloo College of Medicine, Shandong University, Jinan 250012, China;
2. Department of Ophthalmology, Shandong Provincial Hospital, Jinan 250021, China;
3. Department of Ophthalmology, The Second Hospital of Shandong University, Jinan 250033, China;
4. Graduate School, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan 250117, China;

Corresponding author：

Zhao Bojun, Email: 15168860708@163.com

Keywords：

Choroidal vascular index; Diabetic retinopathy; Optical coherence tomography; Review

DOI：

10.3760/cma.j.cn511434-20220902-00487

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Diabetic retinopathy (DR) is the main cause of blindness in diabetic patients. Early diagnosis and intervention are essential to improve the quality of life of patients with DR. Choroidal vascularity index (CVI) is the ratio of choroidal luminal area to total area, which can reflect the structure and blood flow of the choroid, and has been used to evaluate the choroidal condition in various eye diseases. CVI has shown great potential in the prediction, early intervention, disease assessment, and prognosis of DR. The relationship between CVI and photoreceptors needs more research, and CVI may be used as a predictive indicator of photoreceptor health and visual prognosis. In addition, the study of CVI at different layers of the choroid is limited by the accuracy of stratification and the repeatability of measurement. Artificial intelligence and other technologies may provide solutions for this. In the future, through more comprehensive study and the help of artificial intelligence, the value of CVI will be further enriched, which is of great significance for the elucidation of the pathogenesis of DR and serving the clinic.

Citation： Wang Xiaokun, Wu Chao, Cui Yanyan, Chang Weiwei, Zhao Bojun. Research progress of choroidal vascular index in diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2023, 39(12): 1016-1021. doi: 10.3760/cma.j.cn511434-20220902-00487 Copy

1.	Wong TY, Cheung CM, Larsen M, et al. Diabetic retinopathy[J/OL]. Nat Rev Dis Primers, 2016, 2: 16012[2016-03-17]. https://pubmed.ncbi.nlm.nih.gov/27159554/. DOI: 10.1038/nrdp.2016.12.
2.	Jee D, Lee WK, Kang S. Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008-2011[J]. Invest Ophthalmol Vis Sci, 2013, 54(10): 6827-6833. DOI: 10.1167/iovs.13-12654.
3.	Lin KY, Hsih WH, Lin YB, et al. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy[J]. J Diabetes Investig, 2021, 12(8): 1322-1325. DOI: 10.1111/jdi.13480.
4.	Antonetti DA, Klein R, Gardner TW. Diabetic retinopathy[J]. N Engl J Med, 2012, 366(13): 1227-1239. DOI: 10.1056/NEJMra1005073.
5.	Delaey C, Van De Voorde J. Regulatory mechanisms in the retinal and choroidal circulation[J]. Ophthalmic Res, 2000, 32(6): 249-256. DOI: 10.1159/000055622.
6.	Nickla DL, Wallman J. The multifunctional choroid[J]. Prog Retin Eye Res, 2010, 29(2): 144-168. DOI: 10.1016/j.preteyeres.2009.12.002.
7.	Tan KA, Gupta P, Agarwal A, et al. State of science: choroidal thickness and systemic health[J]. Surv Ophthalmol, 2016, 61(5): 566-581. DOI: 10.1016/j.survophthal.2016.02.007.
8.	Campos A, Campos EJ, Martins J, et al. Viewing the choroid: where we stand, challenges and contradictions in diabetic retinopathy and diabetic macular oedema[J]. Acta Ophthalmol, 2017, 95(5): 446-459. DOI: 10.1111/aos.13210.
9.	Foo VHX, Gupta P, Nguyen QD, et al. Decrease in choroidal vascularity index of Haller's layer in diabetic eyes precedes retinopathy[J/OL]. BMJ Open Diabetes Res Care, 2020, 8(1): e001295[2020-09-01]. https://pubmed.ncbi.nlm.nih.gov/32912848/. DOI: 10.1136/bmjdrc-2020-001295.
10.	Muir ER, Rentería RC, Duong TQ. Reduced ocular blood flow as an early indicator of diabetic retinopathy in a mouse model of diabetes[J]. Invest Ophthalmol Vis Sci, 2012, 53(10): 6488-6494. DOI: 10.1167/iovs.12-9758.
11.	Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography[J]. Am J Ophthalmol, 2008, 146(4): 496-500. DOI: 10.1016/j.ajo.2008.05.032.
12.	Wei X, Ting DSW, Ng WY, et al. Choroidal vascularity index: a novel optical coherence tomography based parameter in patients with exudative age-related macular degeneration[J]. Retina, 2017, 37(6): 1120-1125. DOI: 10.1097/IAE.0000000000001312.
13.	Lee SW, Yu SY, Seo KH, et al. Diurnal variation in choroidal thickness in relation to sex, axial length, and baseline choroidal thickness in healthy Korean subjects[J]. Retina, 2014, 34(2): 385-393. DOI: 10.1097/IAE.0b013e3182993f29.
14.	Iovino C, Pellegrini M, Bernabei F, et al. Choroidal vascularity index: an in-depth analysis of this novel optical coherence tomography parameter[J]. J Clin Med, 2020, 9(2): 595. DOI: 10.3390/jcm9020595.
15.	Branchini LA, Adhi M, Regatieri CV, et al. Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography[J]. Ophthalmology, 2013, 120(9): 1901-1908. DOI: 10.1016/j.ophtha.2013.01.066.
16.	Sonoda S, Sakamoto T, Yamashita T, et al. Choroidal structure in normal eyes and after photodynamic therapy determined by binarization of optical coherence tomographic images[J]. Invest Ophthalmol Vis Sci, 2014, 55(6): 3893-3899. DOI: 10.1167/iovs.14-14447.
17.	Agrawal R, Salman M, Tan KA, et al. Choroidal vascularity index (CVI)--a novel optical coherence tomography parameter for monitoring patients with panuveitis?[J/OL]. PLoS One, 2016, 11(1): e0146344[2016-01-11]. https://pubmed.ncbi.nlm.nih.gov/26751702/. DOI: 10.1371/journal.pone.0146344.
18.	Liu G, Li Y, Hu Y, et al. Influence of lifestyle on incident cardiovascular disease and mortality in patients with diabetes mellitus[J]. J Am Coll Cardiol, 2018, 71(25): 2867-2876. DOI: 10.1016/j.jacc.2018.04.027.
19.	Sinclair SH, Schwartz SS. Diabetic retinopathy-an underdiagnosed and undertreated inflammatory, neuro-vascular complication of diabetes[J]. Front Endocrinol (Lausanne), 2019, 10: 843. DOI: 10.3389/fendo.2019.00843.
20.	Kim M, Ha MJ, Choi SY, et al. Choroidal vascularity index in type-2 diabetes analyzed by swept-source optical coherence tomography[J/OL]. Sci Rep, 2018, 8(1): 70[2018-01-08]. https://pubmed.ncbi.nlm.nih.gov/29311618/. DOI: 10.1038/s41598-017-18511-7.
21.	Temel E, Özcan G, Yanık Ö, et al. Choroidal structural alterations in diabetic patients in association with disease duration, HbA1c level, and presence of retinopathy[J]. Int Ophthalmol, 2022, 42(12): 3661-3672. DOI: 10.1007/s10792-022-02363-w.
22.	Endo H, Kase S, Ito Y, et al. Relationship between choroidal structure and duration of diabetes[J]. Graefe's Arch Clin Exp Ophthalmol, 2019, 257(6): 1133-1140. DOI: 10.1007/s00417-019-04295-1.
23.	Romero-Aroca P, Navarro-Gil R, Valls-Mateu A, et al. Differences in incidence of diabetic retinopathy between type 1 and 2 diabetes mellitus: a nine-year follow-up study[J]. Br J Ophthalmol, 2017, 101(10): 1346-1351. DOI: 10.1136/bjophthalmol-2016-310063.
24.	Aksoy M, Simsek M, Apaydın M. Choroidal vascularity index in patients with type-1 diabetes mellitus without diabetic retinopathy[J]. Curr Eye Res, 2021, 46(6): 865-870. DOI: 10.1080/02713683.2020.1846755.
25.	Giblin MJ, Ontko CD, Penn JS. Effect of cytokine-induced alterations in extracellular matrix composition on diabetic retinopathy-relevant endothelial cell behaviors[J/OL]. Sci Rep, 2022, 12(1): 12955[2022-07-28]. https://pubmed.ncbi.nlm.nih.gov/35902594/. DOI: 10.1038/s41598-022-12683-7.
26.	Sinha B, Ghosal S. A target HbA1c between 7 and 7.7% reduces microvascular and macrovascular events in T2D regardless of duration of diabetes: a meta-analysis of randomized controlled trials[J]. Diabetes Ther, 2021, 12(6): 1661-1676. DOI: 10.1007/s13300-021-01062-6.
27.	Nicolini N, Tombolini B, Barresi C, et al. Assessment of diabetic choroidopathy using ultra-widefield optical coherence tomography[J]. Transl Vis Sci Technol, 2022, 11(3): 35. DOI: 10.1167/tvst.11.3.35.
28.	Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs-an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group[J]. Ophthalmology, 1991, 98(Suppl): 786-806.
29.	中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年)[J]. 中华眼科杂志, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.Ocular Fundus Diseases Group of Ophthalmology Branch of Chinese Medical Association. Clinical guidelines for the diagnosis and treatment of diabetic retinopathy in China (2014)[J]. Chin J Ophthalmol, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.
30.	Wang H, Tao Y. Choroidal structural changes correlate with severity of diabetic retinopathy in diabetes mellitus[J]. BMC Ophthalmol, 2019, 19(1): 186. DOI: 10.1186/s12886-019-1189-8.
31.	Marques JH, Marta A, Castro C, et al. Choroidal changes and associations with visual acuity in diabetic patients[J]. Int J Retina Vitreous, 2022, 8(1): 6. DOI: 10.1186/s40942-021-00355-z.
32.	Kakiuchi N, Terasaki H, Sonoda S, et al. Regional differences of choroidal structure determined by wide-field optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2019, 60(7): 2614-2622. DOI: 10.1167/iovs.18-24296.
33.	Le NT, Kroeger ZA, Lin WV, et al. Novel treatments for diabetic macular edema and proliferative diabetic retinopathy[J]. Curr Diab Rep, 2021, 21(10): 43. DOI: 10.1007/s11892-021-01412-5.
34.	Melancia D, Vicente A, Cunha JP, et al. Diabetic choroidopathy: a review of the current literature[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(8): 1453-1461. DOI: 10.1007/s00417-016-3360-8.
35.	Gupta C, Tan R, Mishra C, et al. Choroidal structural analysis in eyes with diabetic retinopathy and diabetic macular edema-a novel OCT based imaging biomarker[J/OL]. PLoS One, 2018, 13(12): e0207435[2018-12-11]. https://pubmed.ncbi.nlm.nih.gov/30533048/. DOI: 10.1371/journal.pone.0207435.
36.	Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group[J]. Ophthalmology, 1991, 98(Suppl): 766-785.
37.	El Rami H, Barham R, Sun JK, et al. Evidence-based treatment of diabetic retinopathy[J]. Semin Ophthalmol, 2017, 32(1): 67-74. DOI: 10.1080/08820538.2016.1228397.
38.	Kim JT, Park N. Changes in choroidal vascular parameters following pan-retinal photocoagulation using swept-source optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(1): 39-47. DOI: 10.1007/s00417-019-04475-z.
39.	Okamoto M, Yamashita M, Ogata N. Effects of intravitreal injection of ranibizumab on choroidal structure and blood flow in eyes with diabetic macular edema[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(5): 885-892. DOI: 10.1007/s00417-018-3939-3.
40.	Song Y, Tani T, Omae T, et al. Retinal blood flow reduction after panretinal photocoagulation in type 2 diabetes mellitus: doppler optical coherence tomography flowmeter pilot study[J/OL]. PLoS One, 2018, 13(11): e0207288[2018-11-08]. https://pubmed.ncbi.nlm.nih.gov/30408113/. DOI: 10.1371/journal.pone.0207288.
41.	Iwase T, Kobayashi M, Yamamoto K, et al. Effects of photocoagulation on ocular blood flow in patients with severe non-proliferative diabetic retinopathy[J/OL]. PLoS One, 2017, 12(3): e0174427[2017-03-29]. https://pubmed.ncbi.nlm.nih.gov/28355247/. DOI: 10.1371/journal.pone.0174427.
42.	Daruich A, Matet A, Moulin A, et al. Mechanisms of macular edema: beyond the surface[J]. Prog Retin Eye Res, 2018, 63: 20-68. DOI: 10.1016/j.preteyeres.2017.10.006.
43.	Cui L, Jiao B, Han Q. Effect of intravitreal anti-vascular growth factor agents with or without macular photocoagulation on diabetic macular edema: a systematic review and meta-analysis[J]. Diabetes Ther, 2019, 10(4): 1283-1296. DOI: 10.1007/s13300-019-0631-5.
44.	Saint-Geniez M, Maldonado AE, D'Amore PA. VEGF expression and receptor activation in the choroid during development and in the adult[J]. Invest Ophthalmol Vis Sci, 2006, 47(7): 3135-3142. DOI: 10.1167/iovs.05-1229.
45.	Kase S, Endo H, Takahashi M, et al. Alteration of choroidal vascular structure in diabetic retinopathy[J]. Br J Ophthalmol, 2020, 104(3): 417-421. DOI: 10.1136/bjophthalmol-2019-314273.
46.	Sonoda S, Sakamoto T, Shirasawa M, et al. Correlation between reflectivity of subretinal fluid in OCT images and concentration of intravitreal VEGF in eyes with diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2013, 54(8): 5367-5374. DOI: 10.1167/iovs.13-12382.
47.	Sonoda S, Sakamoto T, Yamashita T, et al. Effect of intravitreal triamcinolone acetonide or bevacizumab on choroidal thickness in eyes with diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2014, 55(6): 3979-3985. DOI: 10.1167/iovs.14-14188.
48.	Laíns I, Figueira J, Santos AR, et al. Choroidal thickness in diabetic retinopathy: the influence of antiangiogenic therapy[J]. Retina, 2014, 34(6): 1199-1207. DOI: 10.1097/IAE.0000000000000053.
49.	Pellegrini M, Bernabei F, Mercanti A, et al. Short-term choroidal vascular changes after aflibercept therapy for neovascular age-related macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol, 2021, 259(4): 911-918. DOI: 10.1007/s00417-020-04957-5.
50.	Kase S, Endo H, Takahashi M, et al. Involvements of choroidal vascular structures with local treatments in patients with diabetic macular edema[J]. Eur J Ophthalmol, 2022, 32(1): 450-459. DOI: 10.1177/11206721211027103.
51.	Cole ED, Novais EA, Louzada RN, et al. Visualization of changes in the choriocapillaris, choroidal vessels, and retinal morphology after focal laser photocoagulation using OCT angiography[J]. Invest Ophthalmol Vis Sci, 2016, 57(9): 356-361. DOI: 10.1167/iovs.15-18473.
52.	Zhang Z, Meng X, Wu Z, et al. Changes in choroidal thickness after panretinal photocoagulation for diabetic retinopathy: a 12-week longitudinal study[J]. Invest Ophthalmol Vis Sci, 2015, 56(4): 2631-2638. DOI: 10.1167/iovs.14-16226.
53.	Rizzo S, Savastano A, Finocchio L, et al. Choroidal vascularity index changes after vitreomacular surgery[J/OL]. Acta Ophthalmol, 2018, 96(8): e950-e955[2018-05-31]. https://pubmed.ncbi.nlm.nih.gov/29855162/. DOI: 10.1111/aos.13776.
54.	Kang EC, Lee KH, Koh HJ. Changes in choroidal thickness after vitrectomy for epiretinal membrane combined with vitreomacular traction[J/OL]. Acta Ophthalmol, 2017, 95(5): e393-e398[2016-05-27]. https://pubmed.ncbi.nlm.nih.gov/27229756/. DOI: 10.1111/aos.13097.
55.	Yamamoto K, Iwase T, Ushida H, et al. Changes in retinochoroidal thickness after vitrectomy for proliferative diabetic retinopathy[J]. Invest Ophthalmol Vis Sci, 2015, 56(5): 3034-3040. DOI: 10.1167/iovs.14-15981.
56.	Kang EC, Koh HJ. Effects of vitreomacular adhesion on age-related macular degeneration[J/OL]. J Ophthalmol, 2015, 2015: 865083[2015-09-03]. https://pubmed.ncbi.nlm.nih.gov/26425354/. DOI: 10.1155/2015/865083.
57.	Sebag J. Vitreous: the resplendent enigma[J]. Br J Ophthalmol, 2009, 93(8): 989-991. DOI: 10.1136/bjo.2009.157313.
58.	Kinoshita H, Suzuma K, Maki T, et al. Cyclic stretch and hypertension increase retinal succinate: potential mechanisms for exacerbation of ocular neovascularization by mechanical stress[J]. Invest Ophthalmol Vis Sci, 2014, 55(7): 4320-4326. DOI: 10.1167/iovs.13-13839.
59.	Beebe DC, Shui YB, Siegfried CJ, et al. Preserve the (intraocular) environment: the importance of maintaining normal oxygen gradients in the eye[J]. Jpn J Ophthalmol, 2014, 58(3): 225-231. DOI: 10.1007/s10384-014-0318-4.
60.	Iuliano L, Fogliato G, Querques G, et al. Retinal vascular changes after vitrectomy for idiopathic epiretinal membrane: a pilot study with dynamic vessel analysis[J]. Graefe's Arch Clin Exp Ophthalmol, 2017, 255(7): 1325-1332. DOI: 10.1007/s00417-017-3643-8.
61.	Borrelli E, Palmieri M, Viggiano P, et al. Photoreceptor damage in diabetic choroidopathy[J]. Retina, 2020, 40(6): 1062-1069. DOI: 10.1097/IAE.0000000000002538.
62.	Torabi H, Saberi Isfeedvajani M, Ramezani M, et al. Choroidal thickness and hemoglobin A1c levels in patients with type 2 diabetes mellitus[J]. J Ophthalmic Vis Res, 2019, 14(3): 285-290. DOI: 10.18502/jovr.v14i3.4784.
63.	Singh SR, Invernizzi A, Rasheed MA, et al. Wide-field choroidal vascularity in healthy eyes[J]. Am J Ophthalmol, 2018, 193: 100-105. DOI: 10.1016/j.ajo.2018.06.016.
64.	Ruiz-Medrano J, Ruiz-Moreno JM, Goud A, et al. Age-related changes in choroidal vascular density of healthy subjects based on image binarization of swept-source optical coherence tomography[J]. Retina, 2018, 38(3): 508-515. DOI: 10.1097/IAE.0000000000001571.
65.	Wei X, Kumar S, Ding J, et al. Choroidal structural changes in smokers measured using choroidal vascularity index[J]. Invest Ophthalmol Vis Sci, 2019, 60(5): 1316-1320. DOI: 10.1167/iovs.18-25764.
66.	Aşıkgarip N, Temel E, Kıvrak A, et al. Choroidal structural changes and choroidal vascularity index in patients with systemic hypertension[J]. Eur J Ophthalmol, 2022, 32(4): 2427-2432. DOI: 10.1177/11206721211035615.
67.	Agarwal A, Saini A, Mahajan S, et al. Effect of weight loss on the retinochoroidal structural alterations among patients with exogenous obesity[J/OL]. PLoS One, 2020, 15(7): e0235926[2020-07-09]. https://pubmed.ncbi.nlm.nih.gov/32645116/. DOI: 10.1371/journal.pone.0235926.

1. Wong TY, Cheung CM, Larsen M, et al. Diabetic retinopathy[J/OL]. Nat Rev Dis Primers, 2016, 2: 16012[2016-03-17]. https://pubmed.ncbi.nlm.nih.gov/27159554/. DOI: 10.1038/nrdp.2016.12.
2. Jee D, Lee WK, Kang S. Prevalence and risk factors for diabetic retinopathy: the Korea National Health and Nutrition Examination Survey 2008-2011[J]. Invest Ophthalmol Vis Sci, 2013, 54(10): 6827-6833. DOI: 10.1167/iovs.13-12654.
3. Lin KY, Hsih WH, Lin YB, et al. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy[J]. J Diabetes Investig, 2021, 12(8): 1322-1325. DOI: 10.1111/jdi.13480.
4. Antonetti DA, Klein R, Gardner TW. Diabetic retinopathy[J]. N Engl J Med, 2012, 366(13): 1227-1239. DOI: 10.1056/NEJMra1005073.
5. Delaey C, Van De Voorde J. Regulatory mechanisms in the retinal and choroidal circulation[J]. Ophthalmic Res, 2000, 32(6): 249-256. DOI: 10.1159/000055622.
6. Nickla DL, Wallman J. The multifunctional choroid[J]. Prog Retin Eye Res, 2010, 29(2): 144-168. DOI: 10.1016/j.preteyeres.2009.12.002.
7. Tan KA, Gupta P, Agarwal A, et al. State of science: choroidal thickness and systemic health[J]. Surv Ophthalmol, 2016, 61(5): 566-581. DOI: 10.1016/j.survophthal.2016.02.007.
8. Campos A, Campos EJ, Martins J, et al. Viewing the choroid: where we stand, challenges and contradictions in diabetic retinopathy and diabetic macular oedema[J]. Acta Ophthalmol, 2017, 95(5): 446-459. DOI: 10.1111/aos.13210.
9. Foo VHX, Gupta P, Nguyen QD, et al. Decrease in choroidal vascularity index of Haller's layer in diabetic eyes precedes retinopathy[J/OL]. BMJ Open Diabetes Res Care, 2020, 8(1): e001295[2020-09-01]. https://pubmed.ncbi.nlm.nih.gov/32912848/. DOI: 10.1136/bmjdrc-2020-001295.
10. Muir ER, Rentería RC, Duong TQ. Reduced ocular blood flow as an early indicator of diabetic retinopathy in a mouse model of diabetes[J]. Invest Ophthalmol Vis Sci, 2012, 53(10): 6488-6494. DOI: 10.1167/iovs.12-9758.
11. Spaide RF, Koizumi H, Pozzoni MC. Enhanced depth imaging spectral-domain optical coherence tomography[J]. Am J Ophthalmol, 2008, 146(4): 496-500. DOI: 10.1016/j.ajo.2008.05.032.
12. Wei X, Ting DSW, Ng WY, et al. Choroidal vascularity index: a novel optical coherence tomography based parameter in patients with exudative age-related macular degeneration[J]. Retina, 2017, 37(6): 1120-1125. DOI: 10.1097/IAE.0000000000001312.
13. Lee SW, Yu SY, Seo KH, et al. Diurnal variation in choroidal thickness in relation to sex, axial length, and baseline choroidal thickness in healthy Korean subjects[J]. Retina, 2014, 34(2): 385-393. DOI: 10.1097/IAE.0b013e3182993f29.
14. Iovino C, Pellegrini M, Bernabei F, et al. Choroidal vascularity index: an in-depth analysis of this novel optical coherence tomography parameter[J]. J Clin Med, 2020, 9(2): 595. DOI: 10.3390/jcm9020595.
15. Branchini LA, Adhi M, Regatieri CV, et al. Analysis of choroidal morphologic features and vasculature in healthy eyes using spectral-domain optical coherence tomography[J]. Ophthalmology, 2013, 120(9): 1901-1908. DOI: 10.1016/j.ophtha.2013.01.066.
16. Sonoda S, Sakamoto T, Yamashita T, et al. Choroidal structure in normal eyes and after photodynamic therapy determined by binarization of optical coherence tomographic images[J]. Invest Ophthalmol Vis Sci, 2014, 55(6): 3893-3899. DOI: 10.1167/iovs.14-14447.
17. Agrawal R, Salman M, Tan KA, et al. Choroidal vascularity index (CVI)--a novel optical coherence tomography parameter for monitoring patients with panuveitis?[J/OL]. PLoS One, 2016, 11(1): e0146344[2016-01-11]. https://pubmed.ncbi.nlm.nih.gov/26751702/. DOI: 10.1371/journal.pone.0146344.
18. Liu G, Li Y, Hu Y, et al. Influence of lifestyle on incident cardiovascular disease and mortality in patients with diabetes mellitus[J]. J Am Coll Cardiol, 2018, 71(25): 2867-2876. DOI: 10.1016/j.jacc.2018.04.027.
19. Sinclair SH, Schwartz SS. Diabetic retinopathy-an underdiagnosed and undertreated inflammatory, neuro-vascular complication of diabetes[J]. Front Endocrinol (Lausanne), 2019, 10: 843. DOI: 10.3389/fendo.2019.00843.
20. Kim M, Ha MJ, Choi SY, et al. Choroidal vascularity index in type-2 diabetes analyzed by swept-source optical coherence tomography[J/OL]. Sci Rep, 2018, 8(1): 70[2018-01-08]. https://pubmed.ncbi.nlm.nih.gov/29311618/. DOI: 10.1038/s41598-017-18511-7.
21. Temel E, Özcan G, Yanık Ö, et al. Choroidal structural alterations in diabetic patients in association with disease duration, HbA1c level, and presence of retinopathy[J]. Int Ophthalmol, 2022, 42(12): 3661-3672. DOI: 10.1007/s10792-022-02363-w.
22. Endo H, Kase S, Ito Y, et al. Relationship between choroidal structure and duration of diabetes[J]. Graefe's Arch Clin Exp Ophthalmol, 2019, 257(6): 1133-1140. DOI: 10.1007/s00417-019-04295-1.
23. Romero-Aroca P, Navarro-Gil R, Valls-Mateu A, et al. Differences in incidence of diabetic retinopathy between type 1 and 2 diabetes mellitus: a nine-year follow-up study[J]. Br J Ophthalmol, 2017, 101(10): 1346-1351. DOI: 10.1136/bjophthalmol-2016-310063.
24. Aksoy M, Simsek M, Apaydın M. Choroidal vascularity index in patients with type-1 diabetes mellitus without diabetic retinopathy[J]. Curr Eye Res, 2021, 46(6): 865-870. DOI: 10.1080/02713683.2020.1846755.
25. Giblin MJ, Ontko CD, Penn JS. Effect of cytokine-induced alterations in extracellular matrix composition on diabetic retinopathy-relevant endothelial cell behaviors[J/OL]. Sci Rep, 2022, 12(1): 12955[2022-07-28]. https://pubmed.ncbi.nlm.nih.gov/35902594/. DOI: 10.1038/s41598-022-12683-7.
26. Sinha B, Ghosal S. A target HbA1c between 7 and 7.7% reduces microvascular and macrovascular events in T2D regardless of duration of diabetes: a meta-analysis of randomized controlled trials[J]. Diabetes Ther, 2021, 12(6): 1661-1676. DOI: 10.1007/s13300-021-01062-6.
27. Nicolini N, Tombolini B, Barresi C, et al. Assessment of diabetic choroidopathy using ultra-widefield optical coherence tomography[J]. Transl Vis Sci Technol, 2022, 11(3): 35. DOI: 10.1167/tvst.11.3.35.
28. Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs-an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group[J]. Ophthalmology, 1991, 98(Suppl): 786-806.
29. 中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南(2014年)[J]. 中华眼科杂志, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.Ocular Fundus Diseases Group of Ophthalmology Branch of Chinese Medical Association. Clinical guidelines for the diagnosis and treatment of diabetic retinopathy in China (2014)[J]. Chin J Ophthalmol, 2014, 50(11): 851-865. DOI: 10.3760/cma.j.issn.0412-4081.2014.11.014.
30. Wang H, Tao Y. Choroidal structural changes correlate with severity of diabetic retinopathy in diabetes mellitus[J]. BMC Ophthalmol, 2019, 19(1): 186. DOI: 10.1186/s12886-019-1189-8.
31. Marques JH, Marta A, Castro C, et al. Choroidal changes and associations with visual acuity in diabetic patients[J]. Int J Retina Vitreous, 2022, 8(1): 6. DOI: 10.1186/s40942-021-00355-z.
32. Kakiuchi N, Terasaki H, Sonoda S, et al. Regional differences of choroidal structure determined by wide-field optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2019, 60(7): 2614-2622. DOI: 10.1167/iovs.18-24296.
33. Le NT, Kroeger ZA, Lin WV, et al. Novel treatments for diabetic macular edema and proliferative diabetic retinopathy[J]. Curr Diab Rep, 2021, 21(10): 43. DOI: 10.1007/s11892-021-01412-5.
34. Melancia D, Vicente A, Cunha JP, et al. Diabetic choroidopathy: a review of the current literature[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(8): 1453-1461. DOI: 10.1007/s00417-016-3360-8.
35. Gupta C, Tan R, Mishra C, et al. Choroidal structural analysis in eyes with diabetic retinopathy and diabetic macular edema-a novel OCT based imaging biomarker[J/OL]. PLoS One, 2018, 13(12): e0207435[2018-12-11]. https://pubmed.ncbi.nlm.nih.gov/30533048/. DOI: 10.1371/journal.pone.0207435.
36. Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group[J]. Ophthalmology, 1991, 98(Suppl): 766-785.
37. El Rami H, Barham R, Sun JK, et al. Evidence-based treatment of diabetic retinopathy[J]. Semin Ophthalmol, 2017, 32(1): 67-74. DOI: 10.1080/08820538.2016.1228397.
38. Kim JT, Park N. Changes in choroidal vascular parameters following pan-retinal photocoagulation using swept-source optical coherence tomography[J]. Graefe's Arch Clin Exp Ophthalmol, 2020, 258(1): 39-47. DOI: 10.1007/s00417-019-04475-z.
39. Okamoto M, Yamashita M, Ogata N. Effects of intravitreal injection of ranibizumab on choroidal structure and blood flow in eyes with diabetic macular edema[J]. Graefe's Arch Clin Exp Ophthalmol, 2018, 256(5): 885-892. DOI: 10.1007/s00417-018-3939-3.
40. Song Y, Tani T, Omae T, et al. Retinal blood flow reduction after panretinal photocoagulation in type 2 diabetes mellitus: doppler optical coherence tomography flowmeter pilot study[J/OL]. PLoS One, 2018, 13(11): e0207288[2018-11-08]. https://pubmed.ncbi.nlm.nih.gov/30408113/. DOI: 10.1371/journal.pone.0207288.
41. Iwase T, Kobayashi M, Yamamoto K, et al. Effects of photocoagulation on ocular blood flow in patients with severe non-proliferative diabetic retinopathy[J/OL]. PLoS One, 2017, 12(3): e0174427[2017-03-29]. https://pubmed.ncbi.nlm.nih.gov/28355247/. DOI: 10.1371/journal.pone.0174427.
42. Daruich A, Matet A, Moulin A, et al. Mechanisms of macular edema: beyond the surface[J]. Prog Retin Eye Res, 2018, 63: 20-68. DOI: 10.1016/j.preteyeres.2017.10.006.
43. Cui L, Jiao B, Han Q. Effect of intravitreal anti-vascular growth factor agents with or without macular photocoagulation on diabetic macular edema: a systematic review and meta-analysis[J]. Diabetes Ther, 2019, 10(4): 1283-1296. DOI: 10.1007/s13300-019-0631-5.
44. Saint-Geniez M, Maldonado AE, D'Amore PA. VEGF expression and receptor activation in the choroid during development and in the adult[J]. Invest Ophthalmol Vis Sci, 2006, 47(7): 3135-3142. DOI: 10.1167/iovs.05-1229.
45. Kase S, Endo H, Takahashi M, et al. Alteration of choroidal vascular structure in diabetic retinopathy[J]. Br J Ophthalmol, 2020, 104(3): 417-421. DOI: 10.1136/bjophthalmol-2019-314273.
46. Sonoda S, Sakamoto T, Shirasawa M, et al. Correlation between reflectivity of subretinal fluid in OCT images and concentration of intravitreal VEGF in eyes with diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2013, 54(8): 5367-5374. DOI: 10.1167/iovs.13-12382.
47. Sonoda S, Sakamoto T, Yamashita T, et al. Effect of intravitreal triamcinolone acetonide or bevacizumab on choroidal thickness in eyes with diabetic macular edema[J]. Invest Ophthalmol Vis Sci, 2014, 55(6): 3979-3985. DOI: 10.1167/iovs.14-14188.
48. Laíns I, Figueira J, Santos AR, et al. Choroidal thickness in diabetic retinopathy: the influence of antiangiogenic therapy[J]. Retina, 2014, 34(6): 1199-1207. DOI: 10.1097/IAE.0000000000000053.
49. Pellegrini M, Bernabei F, Mercanti A, et al. Short-term choroidal vascular changes after aflibercept therapy for neovascular age-related macular degeneration[J]. Graefe's Arch Clin Exp Ophthalmol, 2021, 259(4): 911-918. DOI: 10.1007/s00417-020-04957-5.
50. Kase S, Endo H, Takahashi M, et al. Involvements of choroidal vascular structures with local treatments in patients with diabetic macular edema[J]. Eur J Ophthalmol, 2022, 32(1): 450-459. DOI: 10.1177/11206721211027103.
51. Cole ED, Novais EA, Louzada RN, et al. Visualization of changes in the choriocapillaris, choroidal vessels, and retinal morphology after focal laser photocoagulation using OCT angiography[J]. Invest Ophthalmol Vis Sci, 2016, 57(9): 356-361. DOI: 10.1167/iovs.15-18473.
52. Zhang Z, Meng X, Wu Z, et al. Changes in choroidal thickness after panretinal photocoagulation for diabetic retinopathy: a 12-week longitudinal study[J]. Invest Ophthalmol Vis Sci, 2015, 56(4): 2631-2638. DOI: 10.1167/iovs.14-16226.
53. Rizzo S, Savastano A, Finocchio L, et al. Choroidal vascularity index changes after vitreomacular surgery[J/OL]. Acta Ophthalmol, 2018, 96(8): e950-e955[2018-05-31]. https://pubmed.ncbi.nlm.nih.gov/29855162/. DOI: 10.1111/aos.13776.
54. Kang EC, Lee KH, Koh HJ. Changes in choroidal thickness after vitrectomy for epiretinal membrane combined with vitreomacular traction[J/OL]. Acta Ophthalmol, 2017, 95(5): e393-e398[2016-05-27]. https://pubmed.ncbi.nlm.nih.gov/27229756/. DOI: 10.1111/aos.13097.
55. Yamamoto K, Iwase T, Ushida H, et al. Changes in retinochoroidal thickness after vitrectomy for proliferative diabetic retinopathy[J]. Invest Ophthalmol Vis Sci, 2015, 56(5): 3034-3040. DOI: 10.1167/iovs.14-15981.
56. Kang EC, Koh HJ. Effects of vitreomacular adhesion on age-related macular degeneration[J/OL]. J Ophthalmol, 2015, 2015: 865083[2015-09-03]. https://pubmed.ncbi.nlm.nih.gov/26425354/. DOI: 10.1155/2015/865083.
57. Sebag J. Vitreous: the resplendent enigma[J]. Br J Ophthalmol, 2009, 93(8): 989-991. DOI: 10.1136/bjo.2009.157313.
58. Kinoshita H, Suzuma K, Maki T, et al. Cyclic stretch and hypertension increase retinal succinate: potential mechanisms for exacerbation of ocular neovascularization by mechanical stress[J]. Invest Ophthalmol Vis Sci, 2014, 55(7): 4320-4326. DOI: 10.1167/iovs.13-13839.
59. Beebe DC, Shui YB, Siegfried CJ, et al. Preserve the (intraocular) environment: the importance of maintaining normal oxygen gradients in the eye[J]. Jpn J Ophthalmol, 2014, 58(3): 225-231. DOI: 10.1007/s10384-014-0318-4.
60. Iuliano L, Fogliato G, Querques G, et al. Retinal vascular changes after vitrectomy for idiopathic epiretinal membrane: a pilot study with dynamic vessel analysis[J]. Graefe's Arch Clin Exp Ophthalmol, 2017, 255(7): 1325-1332. DOI: 10.1007/s00417-017-3643-8.
61. Borrelli E, Palmieri M, Viggiano P, et al. Photoreceptor damage in diabetic choroidopathy[J]. Retina, 2020, 40(6): 1062-1069. DOI: 10.1097/IAE.0000000000002538.
62. Torabi H, Saberi Isfeedvajani M, Ramezani M, et al. Choroidal thickness and hemoglobin A1c levels in patients with type 2 diabetes mellitus[J]. J Ophthalmic Vis Res, 2019, 14(3): 285-290. DOI: 10.18502/jovr.v14i3.4784.
63. Singh SR, Invernizzi A, Rasheed MA, et al. Wide-field choroidal vascularity in healthy eyes[J]. Am J Ophthalmol, 2018, 193: 100-105. DOI: 10.1016/j.ajo.2018.06.016.
64. Ruiz-Medrano J, Ruiz-Moreno JM, Goud A, et al. Age-related changes in choroidal vascular density of healthy subjects based on image binarization of swept-source optical coherence tomography[J]. Retina, 2018, 38(3): 508-515. DOI: 10.1097/IAE.0000000000001571.
65. Wei X, Kumar S, Ding J, et al. Choroidal structural changes in smokers measured using choroidal vascularity index[J]. Invest Ophthalmol Vis Sci, 2019, 60(5): 1316-1320. DOI: 10.1167/iovs.18-25764.
66. Aşıkgarip N, Temel E, Kıvrak A, et al. Choroidal structural changes and choroidal vascularity index in patients with systemic hypertension[J]. Eur J Ophthalmol, 2022, 32(4): 2427-2432. DOI: 10.1177/11206721211035615.
67. Agarwal A, Saini A, Mahajan S, et al. Effect of weight loss on the retinochoroidal structural alterations among patients with exogenous obesity[J/OL]. PLoS One, 2020, 15(7): e0235926[2020-07-09]. https://pubmed.ncbi.nlm.nih.gov/32645116/. DOI: 10.1371/journal.pone.0235926.

Previous Article
色素性玻璃体囊肿
Next Article
Research progress on the application of artificial intelligence in the screening and treatment of retinopathy of prematurity

Chinese Journal of Ocular Fundus Diseases

Research progress of choroidal vascular index in diabetic retinopathy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content