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

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...

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Main Authors: M. Hossein Nowroozzadeh, Mansoureh Bagheri
Format: Article
Language:English
Published: BMC 2025-01-01
Series:International Journal of Retina and Vitreous
Subjects:
Online Access:https://doi.org/10.1186/s40942-024-00618-5
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author M. Hossein Nowroozzadeh
Mansoureh Bagheri
author_facet M. Hossein Nowroozzadeh
Mansoureh Bagheri
author_sort M. Hossein Nowroozzadeh
collection DOAJ
description 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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spelling doaj-art-eda30d0e235d43db879d693b3c2dc9172025-02-02T12:35:52ZengBMCInternational Journal of Retina and Vitreous2056-99202025-01-0111111510.1186/s40942-024-00618-5The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic reviewM. Hossein Nowroozzadeh0Mansoureh Bagheri1Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesPoostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical SciencesAbstract 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.https://doi.org/10.1186/s40942-024-00618-5ChoriocapillarisChoroidal vasculatureDiabetic choroidopathyDiabetic retinopathyOptical coherence tomography angiography
spellingShingle M. Hossein Nowroozzadeh
Mansoureh Bagheri
The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review
International Journal of Retina and Vitreous
Choriocapillaris
Choroidal vasculature
Diabetic choroidopathy
Diabetic retinopathy
Optical coherence tomography angiography
title The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review
title_full The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review
title_fullStr The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review
title_full_unstemmed The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review
title_short The role of optical coherence tomography angiography in assessing diabetic choroidopathy: a systematic review
title_sort role of optical coherence tomography angiography in assessing diabetic choroidopathy a systematic review
topic Choriocapillaris
Choroidal vasculature
Diabetic choroidopathy
Diabetic retinopathy
Optical coherence tomography angiography
url https://doi.org/10.1186/s40942-024-00618-5
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