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. 2020 Oct 9;12(10):e10871. doi: 10.7759/cureus.10871

Table 2. Results of the main choroidal parameters of the studies from the review.

CA: choroidal area, CC: choriocapillaris, CCT: central choroidal thickness, CSME: clinically significant macular edema, CT: choroidal thickness, CVI: choroidal vascular index, DME: diabetic macular edema, DT: systemic diabetic treatment, LA: luminal area, L/C ratio: luminal-to-choroidal ratio, ME: macular edema, mmNPDR: mild-to-moderate non-proliferative diabetic retinopathy, msNPDR: moderate-to-severe non-proliferative diabetic retinopathy, NPDR: non-proliferative diabetic retinopathy, OCTA: optical coherence tomography angiography, PDR: proliferative diabetic retinopathy, PRP: pan-retinal photocoagulation, SA: stromal area, SFCT: subfoveal choroidal thickness, SMD: serous macular detachment, TCA: total choroidal area.

Study  Groups   Choroidal Part  Thickness Measurement (μm) CVI Conclusion
Endo et al. [15] Healthy control Total CCT  254±83   The total and outer CCT layers of diabetic eyes were significantly thickened in the DME+DT− as compared with the DME−DT+ group. The total CCT layer and the outer choroidal layer thickness were significantly thicker in the DME+ than in the DME− group in all DME cases examined.
DME+ 283±88  
DME− 251±70  
DME+DT+ 274±88  
DME−DT+ 247±66  
DME+DT− 290±84  
DME−DT− 258±75  
Healthy control Outer CCT  195±75  
DME+ 222±83  
DME− 193±63  
DME+DT+ 214±83  
DME−DT+ 189±58  
DME+DT− 228±77  
DME−DT− 201±70  
Wang and Tao [16] DM SFCT 213.21±19.02 0.63±0.04 Eyes of patients with DM showed that the L/C ratio (equals to CVI) decreased compared with normal controls. The SFCT increased, but the L/C ratio significantly decreased with worsening of DR compared with DM with no DR, and normal eyes.
Healthy control 212.63±11.99 0.68±0.06
DM without DR 194.18±5.68  0.65±0.03
PRP-untreated NPDR 217.29±14.07 0.63±0.05
PRP-untreated PDR 229.25±13.89 0.61±0.04
Gupta et al. [17] Healthy control SFCT 284.53±56.45 67.51±2.86 SFCT was significantly increased in eyes with DME as compared to the controls and showed an ascending trend with worsening of DR, though this difference was not statistically significant. CVI was significantly decreased in DME with DR eyes as compared to controls. CVI was also significantly decreased with worsening DR.
Mild NPDR 304.33±40.39 66.38±0.3
Moderate NPDR 327.81±47.39 65.28±0.37
Severe NPDR 357.72±62.65 63.50±0.47
PDR 334.59±47.4 61.27±0.9
DME 334.47±51.81 63.89±1.89
Rewbury et al. [18] Mild NPDR Mean SFCT 217.7±62   SFCT increased with the severity of DR, especially in the PDR group. DME was associated with a non-statistically significant increase in CT compared with eyes without DME.
msNPDR 221.7±62  
PDR 242.1±48  
DME− 209.3±61  
DME+ 225.4±60  
Ohara et al. [19] Before PRP SFCT 268.4±102.9   CT significantly decreased after PRP, which continued for at least six months after treatment. CT of severe NPDR and PDR was significantly thicker than that of mild-to-moderate NPDR.
One month after PRP 253.4±103.1  
Three months after PRP 253.8±107.1  
Six months after PRP 252.9±110.5  
Healthy control 243±71.4  
DM without DR 251.3±61.9  
 mmNPDR 227.1±71.3  
Severe NPDR 323.1±66.0  
PDR 301.7±80.8  
before PRP Central Field CT 268.6±104.5  
One month after PRP 254.5±105.3  
Three months after PRP 254.2±108.2  
Six months after PRP 248.1±101.8  
Healthy control 248.3±70.7  
DM without DR 250.2±55.4  
mmNPDR 230.0±70.3  
Severe NPDR 323.2±61.3  
PDR 307.3±84.1  
Tan et al. [20] Healthy control Average Choroidal (subfoveal, nasal, and temporal) 180.4±70.50 67.20±0.16 Eyes of patients with DM showed significantly decreased CVI with no corresponding change in CT compared to controls. However, there was a significant decrease in CVI and an increase in TCA, LA, SA, and average CT in DR patients compared with DM without DR. 
DM group 168.37±52.07 65.10±0.20
DM without DR 157.24±48.29 65.30±0.21
DR group 193.68±53.65 64.20±0.16
Hua et al. [21] DME+ SMD−  SFCT 276   In group two, both the SFCT and CA of eyes with DME and SMD were significantly greater than those in the other eyes. The CA in PRP treated cases was also greater than that in non-PRP treated cases.
DME+ SMD+ 364  
Non-PRP treated 288  
PRP-treated 365  
Kim et al. [14] Healthy controls SFCT 320±77.92 69.08±2.29 The eyes of patients with DM, even without DR, exhibited a significantly lower CVI than those of healthy controls. Notably, the PDR group exhibited a significantly lower mean CVI relative to the other DR stages. Eyes of diabetic patients exhibited a lower SFCT than the eyes of healthy controls. Among the eyes of diabetic patients, the lowest CT values were observed in the PDR group.
DM without DR 258.13±89.02 67.07±3.71
mmNPDR 310.22±72.41 66.28±2.70
Severe NPDR 304.53±69.26 66.2±2.56
PDR 258.75±73.29 63.48±2.89
PRP-treated DR 276.29±79.51 65.38±3.15
CSME 312.58±89.59 66.28±2.85
Sudhalkar et al. [22] Healthy controls Mean SFCT 281.7±47.7   Control eyes had greater SFCT compared to subjects with DM, with and without retinopathy. The thinning progressed with increasing severity of DR. SFCT in eyes with ME was not significantly different from eyes without ME.
DM without DR 261.71±51.8  
DM with any form of DR 252.8±55.6  
NPDR 248.0±56.3  
PDR 243.9±56.2  
PRP-treated DR 258.4±48.3  
Non-PRP-treated DR 251.78±56.9  
DME− 246.805±55.61  
DME+ 256.629±55.24  
Totan et al. [23] Healthy controls SFCT 321.4±36.5   Both pulsatile choroidal blood flow and CT were decreased in patients with DME.
DME 273.5±30.2  
Gerendas et al. [24] Healthy controls Total CT in the 6-mm region on the foveal grid 190±23   Total CT in the 6-mm region on the foveal grid is significantly reduced in DME and non-edematous fellow eyes of patients compared with healthy control eyes. There was no statistically significant difference in overall CT between patients’ study eyes with DME and their fellow eyes without DME.
Non-edematous fellow eyes 177±20  
DME 175±23  
Lee et al. [25] Healthy controls SFCT 228.5±38.9   The CT of subfoveal regions was significantly decreased in DR patients compared with controls. The proliferative changes or presence of ME did not result in additional choroidal thinning.
No diabetic change 219.1±47.8  
mmNPDR 158.9±56.3  
Severe NPDR 161.2±38.5  
PDR 157.4±45.7  
DME+ 164.1±63.0  
DME− 157.2±71.1  
Adhi et al. [26] Healthy controls SFCT 276.4±13.4   Choroidal morphological features are altered in patients with moderate to severe DR. The SFCT and the subfoveal medium choroidal vessel layer and CC layer thicknesses are significantly reduced in patients with DR, PDR, and DME compared to controls.
NPDR 252.9±20.27  
PDR 209.6±12.42  
DME  211.6±17.05  
Regatieri et al. [27] Normal Mean SFCT 232.3±15.2   There is a significant decrease in the CT in patients with DME or treated PDR compared to normal subjects. No significant difference between normal subjects and the NPDR group was observed. Between DME and treated PDR groups, there was no significant difference.
NPDR 222±21.6  
DME 169.5±14.7  
PDR 162.7±7.0  
Gołębiewska et al. [28] Diabetic SFCT 355.65   CT remains unchanged in children with Type one DM. There was no significant difference between subjects and controls in the CT in the fovea, nasal, temporal, superior, and inferior quadrants of the macula. However, regardless of the prevalence of Type one DM in the studied children, CT was significantly thicker in girls than in boys, except for the superior quadrant.
Non-diabetic 327.98  
Kim et al. [29] Healthy controls     69.21±2.24 CVI correlated negatively with worsening DR severity, P-value= 0.009.
DM without DR     67.06±3.98
Mild NPDR     66.60±3.03
Moderate NPDR     66.18±3.04
Severe NPDR     66.15±2.63
PDR     63.10±3.45
Dodo et al. [30]         On the ~10-μm and ~29-μm-thick CC slab images, the areas of flow void increased gradually according to the DR severity, and eyes with severe NPDR and PDR had significantly larger areas of flow void and larger non-flow areas than those with no apparent retinopathy. In 12 eyes with ischemic maculopathy, the CC layer beneath the disrupted ellipsoid zone of the photoreceptor (EZ) had greater areas of flow void than did the area beneath an intact EZ.
Nesper et al. [31]         Retinal and CC vascular nonperfusion in OCTA increased significantly with disease severity in eyes with DR.