Research recently published in Frontiers in Medicine characterized the regional variations of choroidal vascularity index (CVI) in patients with pre- and early-stage of DR by using full-range ultra-widefield OCTA (UWF OCTA).

CVI in the central region (0–1 mm) and four quadrants of the concentric rings with different ranges (1–3, 3–6, 6–9, 9–12, 12–15, 15–18 mm) were analyzed in four age-matched groups: no DM (NDM), no DR with early DM (EDM) and late DM (LDM), and mild–moderate non-proliferative diabetic retinopathy (mNPDR). The results showed that the CVI was significantly lower in patients with mild NPDR for most of regions, especially for nasal and temporal periphery. Besides, a notable variance in CVI was observed, particularly in the temporal quadrant of the 15–18 mm range (T18) between the LDM and mNPDR groups indicating that choroidal vascular changes might already exist before DR onset. The CVI in the T18 region demonstrated superior diagnostic efficacy (AUC = 0.755), and when combined with those in other regions and clinical data, the AUC rose to 0.907. UWF-OCTA appeared to be a promising method to predict the onset of DR and promote the early diagnosis of DR.

A 400kHz speed swept-source OCTA (Bmizar, TowardPi Medical) was used in this study to achieve UWF OCTA of the Sattler’s and Haller’s layer and choroid quantifications including 3D-CVI. AI-assisted segmentation algorithm is integrated to ensure high reproducibility and accuracy of the measurements.

This research is authored by Dr. Yulei Chen, etc. team of Prof. Shaolin Du from Dongguan Tungwah Hospital. Link to the original text: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1490831/full