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Patryk Sidorczuk, Barbara Pieklarz, Joanna Konopinska, Emil Saeed, Zofia Mariak, Diana Dmuchowska Department of Ophthalmology, Medical University of Bialystok, Bialystok, 15-276, PolandCorrespondence: Diana DmuchowskaDepartment of Ophthalmology, Medical University of Białystok, 24a M. Sklodowskiej-Curie, Bialystok, 15-276, PolandTel +48857468372Fax +48857468604Email diana.dmuchowska@umb.edu.plPurpose: The aim of the study was to compare two non-overlapping blood supply systems of the retina to obtain a better insight into the relation between diabetic macular retinopathy and choroidopathy. Specifically, the study focused on the relationships between (1) retinal vascular changes around the fovea in fluorescein angiography (FA) and (2) choroidal thickness, volume and other parameters assessed by optical coherence tomography (OCT).Patients and Methods: The retrospective cross-sectional single-center study included 210 eyes from 152 patients with diabetic retinopathy (mean age 60.7± 12.4 years, 49.3% of women; foveal avascular zone [FAZ] outline: 44.3% grade ≤ 2, 55.7% grade ≥ 3). The outline of FAZ, a measure of capillary loss due to ischemic processes, was analyzed on FA according to the Early Treatment Diabetic Retinopathy Study Research Group (ETDRS) standards. The eyes were stratified according to the FAZ outline and size and the presence of clinically significant diabetic macular edema (CSME). Then, resultant groups were compared in terms of the spectral domain OCT parameters: choroidal thickness and volume (within ETDRS subfields), luminal, stromal and total choroidal areas and choroidal vascularity index (based on the foveal scan). Statistical analysis was based on univariate models with the choroidal parameters as independent variables, and age, sex, panretinal photocoagulation, the severity of diabetic retinopathy and CSME as covariates.Results: No significant relationships were found between the FAZ outline and area and choroidal characteristics of patients with diabetic retinopathy. In patients without CSME, no correlation was observed between the FAZ area and choroidal characteristics. In patients with CSME, no correlation was found between the FAZ area and choroidal characteristics other than the choroidal vascularity index.Conclusion: In patients with diabetic retinopathy, damage to the macular retinal vasculature (FAZ) does not seem to be associated with changes in the choroidal vasculature, and these two processes appear to occur independently.Keywords: choroid, choroidal thickness, choroidal volume, choroidal vascularity index, OCT

Background Tissue derived biomarkers may offer utility as indicators of accumulated damage. Reduced thickness of retinal neuronal tissue and the vascular choroid have previously been associated with vascular damage and diabetes. We evaluated associations between retinal thickness, retinal microvascular and choroidal measures, and renal function in a population with a high burden of comorbidity. Methods Participants were recruited from nuclear cardiology or renal medicine clinics. Retinal and choroidal thickness were measured from spectral-domain optical coherence tomograms. Retinal microvascular parameters were assessed from digital fundus photographs using a semi-automated software package. Main Outcome Measure: Chronic kidney disease (CKD) categorised as: CKD stages 1–2, eGFR ≥60 ml/min/1.73m2; CKD stage 3, eGFR 30–59 ml/min/1.73m2, and CKD stages 4–5, eGFR ≤29 ml/min/1.73m2. Results Participants (n = 241) had a mean age of 65 years and a mean eGFR of 66.9 ml/min/1.73m2. Thirty–nine % of the cohort had diabetes and 27% were using diuretics. Thinning of the inner retina and changes to its microvascular blood supply were associated with lower eGFR and CKD stages 4 and 5, while no associations were found between the outer retinal layers or their choroidal blood supply and CKD of any stage. These associations remained following adjustment for age, mean arterial blood pressure, diabetes status, low-density lipoprotein, body mass index, and sex. Conclusions Inner retinal thinning and retinal microvascular variation is associated with advanced CKD (stages 4 & 5) independent of important confounding factors, but not with earlier stage CKD (stage 3) and, therefore, its utility as a biomarker for early CKD is not supported in this study.

To evaluate choroidal volume and thickness changes after photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). Chronic CSC eyes with a history of PDT were selected. Average choroidal volume, average choroidal thickness, the maximum and minimum choroidal thickness of the macula irradiated area and peripheral non-irradiated areas before and after one and three months of treatment were examined. A total of 14 patients with chronic CSC and 9 controls without any eye pathology were enrolled. The mean choroidal volume in CSC before and, and after one and three months of treatment were 2.36 (standard deviation: 0.70), 1.90 (0.69), 1.86 (0.66) mm3 for the central area, 1.25 (0.38), 1.14 (0.35), 1.13 (0.34) mm3 for superior nasal area, 1.47 (0.41), 1.28 (0.43), 1.26 (0.43) mm3 for superior temporal area, 1.07 (0.49), 0.95 (0.38), 0.93 (0.35) mm3 for inferior nasal area, 1.17 (0.38), 1.04 (0.32), 1.03 (0.33) mm3 for inferior temporal area. This study revealed the choroidal volume changes in a short period after PDT and a decrease in unirradiated choroidal volume was also shown after the treatment. The algorithm provided on the ARI Network enables to evaluate the choroidal changes quantitatively and qualitatively.

Simple Summary Choroidopathy is one of the components in the pathogenesis of diabetic macular oedema (DME). This study investigated the optical coherence tomography-based choroidal parameters: thickness, volume, choroidal vascularity index (CVI), luminal area (LA), stromal area (SA), and total choroidal area (TCA) in relation to the presence and type of DME (cystoid, diffuse, and with subretinal fluid). Diabetic choroidopathy seems to play a role in the development of DME but is less likely involved in the pathogenesis of specific types thereof. Abstract Diabetic macular oedema (DME) is an outcome of multiple, complex and not fully understood mechanisms. The aim of this study was to define the role of choroidopathy in the pathogenesis of various DME types. The retrospective cross-sectional single-centre study included 140 eyes from 105 patients with DME and 76 eyes from 52 non-diabetic controls. The eyes were stratified according to the type of DME: cystoid, diffuse, and with subretinal fluid. Optical coherence tomography-based choroidal parameters: thickness, volume, choroidal vascularity index (CVI), luminal area (LA), stromal area (SA), and total choroidal area (TCA) were compared. Eyes with DME, regardless of the type thereof, had lower choroidal thickness, volume, and CVI values than the controls. Further, the eyes with some specific DME types differed significantly from the controls in terms of LA and SA. While the eyes with various DME types did not differ significantly in terms of their choroidal thickness, volume and CVI, some between-group differences were found in LA, SA and TCA. Diabetic choroidopathy seems to play a role in the development of DME but is less likely involved in the pathogenesis of specific types thereof.

The aim of the study is to assess choroidal thickness (CT) and choroidal volume (CV) in 90 type 1 diabetes mellitus (DM1) patients with no diabetic retinopathy (DR) and 60 control eyes using spectral domain optical coherence tomography (SD-OCT) and swept source (SS)-OCT in the areas of the Early Treatment Diabetic Retinopathy Study (ETDRS). Mean ages were 42.93 ± 13.62 and 41.52 ± 13.05 years in the diabetic and control groups, respectively. Significant differences were obtained between both groups with Spectralis SD-OCT in all ETDRS areas and in the total CV, excluding the temporal perifoveal one. With Triton SS-OCT, statistically significant differences were obtained in the subfoveal CT and in the vertical areas. CT showed the same tendency with both OCTs, with greater CT and CV in the DM1 group than the mean values of the control group. To assess the influence of DM1 evolution in the CT modifications, DM1 patients were divided into Group 1, with less than 24 years of diagnosis, and Group 2, with ≥24 years of DM1 evolution. Using both OCTs, seven of the nine ETDRS areas and the CV had lower values in Group 2. CT and CV measured by OCT were higher in DM1 without DR. There is a choroidal thinning related to disease evolution in DM1. In patients with DM evolution greater than 24 years, the CT is statistically lower than in patients with less evolution of the disease. Publication of this article was supported by the General Council of Aragon (Diputación General de Aragón) Group B08_7R, the Health Research Fund Instituto de Salud Carlos III (Fondo de Investigación Sanitaria, Spanish Ministry of Health) PI13/01124, and RETICS-Oftared RD16/0008 and Menarini Laboratories.

Purpose: To evaluate the thickness and volume of the choroid in healthy Korean children using swept-source optical coherence tomography. Methods: We examined 80 eyes of 40 healthy children and teenagers (