Quantitative analysis of retinal and choroidal microvascular changes in patients with diabetes

The relationship between choroidal and retinal microvascular changes has not yet been well described, and there were limited data on diagnostic ability of optical coherence tomography (OCT)-derived vascular parameters for determining diabetic retinopathy (DR) progression. We quantitatively analyzed OCT-derived vascular parameters at superficial (SCP) and deep retinal capillary plexus (DCP), and choroid. We assessed foveal avascular zone (FAZ), vessel density, vessel length density, and choroidal vascularity index in conjunction with DR stage. In this study, patients with diabetes and healthy controls were retrospectively analyzed. One-hundred seventy-four eyes were divided into six groups as follows: Healthy controls, no DR, mild non-proliferative DR (NPDR), moderate NPDR, severe NPDR, and proliferative DR. There were significant quantitative changes in retinal and choroidal vascular parameters with DR progression. The FAZ area and perimeter correlated positively with worsening DR severity; the FAZ circularity index, retinal vessel density, retinal vessel length density, and choroidal vascularity index correlated negatively with worsening severity. Among these, FAZ circulatory index demonstrated good diagnostic performance for DR. Our results cautiously suggest that functional circulatory disturbances in retinal and choroidal vasculatures occur before DR presents. As DR progresses, DCP retinal microvasculature changes precede SCP changes.