The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review.

M Hossein Nowroozzadeh, Mansoureh Bagheri
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Abstract

Background: Diabetic retinopathy (DR) is a leading cause of vision impairment worldwide, affecting both retinal and choroidal vasculature. While advances in imaging technology, particularly optical coherence tomography angiography (OCTA), provide new opportunities to assess choroidal changes in diabetic patients, the role of OCTA in early diagnosis and monitoring of diabetic choroidopathy remains unclear.

Objective: This review aims to evaluate the potential role of OCTA in diagnosing and monitoring diabetic choroidopathy.

Methods: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Databases including PubMed, Embase, Cochrane Library, Google Scholar, ISI, and Scopus were searched for studies on diabetic choroidopathy assessed by OCTA. Studies included were peer-reviewed, published in English, and excluded case reports, conference proceedings, and studies on treated DR patients. Two independent reviewers screened articles for eligibility based on predefined criteria.

Results: OCTA allows for non-invasive, high-resolution visualization of retinal and choroidal microvasculature, providing both qualitative and quantitative data. The majority of studies indicate a significant decrease in choroidal perfusion parameters in diabetic patients without DR compared to healthy controls. Conflicting evidence exists regarding the correlation between choriocapillaris flow reduction and DR severity. OCTA may also predict changes in visual function related to choroidal perfusion, though it cannot fully replace clinical examinations.

Conclusions: OCTA is a valuable tool for early detection and monitoring of diabetic choroidopathy. However, its role is limited by variability in findings and its inability to detect certain features of diabetic microangiopathy. Further studies are needed to clarify its clinical utility and standardize assessment methods.

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光学相干断层扫描血管造影在评估糖尿病脉络膜病变中的作用:一项系统综述。
背景:糖尿病视网膜病变(DR)是世界范围内视力损害的主要原因,影响视网膜和脉络膜血管。虽然成像技术的进步,特别是光学相干断层扫描血管造影(OCTA),为评估糖尿病患者脉络膜病变提供了新的机会,但OCTA在糖尿病脉络膜病的早期诊断和监测中的作用尚不清楚。目的:探讨OCTA在糖尿病脉络膜病变诊断和监测中的潜在作用。方法:按照系统评价和荟萃分析(PRISMA) 2020指南的首选报告项目进行系统评价。检索PubMed、Embase、Cochrane Library、谷歌Scholar、ISI和Scopus等数据库,检索OCTA评估的糖尿病脉络膜病变的研究。纳入的研究经过同行评审,以英文发表,并排除了病例报告、会议记录和治疗DR患者的研究。两名独立审稿人根据预定义的标准筛选文章的资格。结果:OCTA可以实现视网膜和脉络膜微血管的无创、高分辨率可视化,提供定性和定量数据。大多数研究表明,与健康对照相比,无DR的糖尿病患者脉络膜灌注参数显著降低。关于绒毛膜毛细血管血流减少与DR严重程度之间的相关性存在相互矛盾的证据。OCTA也可以预测与脉络膜灌注相关的视觉功能变化,但不能完全取代临床检查。结论:OCTA是早期发现和监测糖尿病脉络膜病变的有效工具。然而,它的作用是有限的变异性的发现和它不能检测糖尿病微血管病变的某些特征。明确其临床应用,规范评估方法,有待进一步研究。
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来源期刊
CiteScore
3.50
自引率
4.30%
发文量
81
审稿时长
19 weeks
期刊介绍: International Journal of Retina and Vitreous focuses on the ophthalmic subspecialty of vitreoretinal disorders. The journal presents original articles on new approaches to diagnosis, outcomes of clinical trials, innovations in pharmacological therapy and surgical techniques, as well as basic science advances that impact clinical practice. Topical areas include, but are not limited to: -Imaging of the retina, choroid and vitreous -Innovations in optical coherence tomography (OCT) -Small-gauge vitrectomy, retinal detachment, chromovitrectomy -Electroretinography (ERG), microperimetry, other functional tests -Intraocular tumors -Retinal pharmacotherapy & drug delivery -Diabetic retinopathy & other vascular diseases -Age-related macular degeneration (AMD) & other macular entities
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