| Early Choroidal Microvascular Alterations Detected by Optical Coherence Tomography 3 Angiography in Diabetic Eyes Without Retinopathy |
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Soyoung Kang, Hyeong Min Kim, Hyungwoo Lee, Hyewon Chung |
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Department of Ophthalmology, Konkuk University Medical Center, Konkuk University College of Medicine, Seoul, Korea |
Correspondence:
Hyewon Chung, Tel: 82-2-2030-7657, Fax: 82-2-2030-5273,
Email: hchung@kuh.ac.kr
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Received: 17 July 2025 • Revised: 22 March 2026 • Accepted: 2 April 2026 |
| Abstract |
Purpose
To evaluate early choroidal microvascular alterations in diabetic eyes without clinically detectable retinopathy using optical coherence tomography angiography (OCTA), with quantitative analysis of choriocapillaris (CC) flow voids and en face Haller’s layer metrics.
Methods
This study included 102 eyes divided into three groups: healthy controls, diabetic patients without DR (no DR group), and those with non-proliferative DR (NPDR group). Spectral-domain OCT and swept-source OCT were used to assess choriocapillaris (CC) voids, Haller’s layer vessels, and subfoveal choroidal thickness (SFCT) lag.
Results
The average size and total area of CC voids significantly increased with DR severity, indicating early microvascular impairment. In contrast, there were no significant differences in the thickness or area of Haller’s layer vessels among the groups. CC void changes were independent of SFCT.
Conclusions
CC void parameters may serve as early imaging biomarkers of diabetic choroidopathy, even before the development of DR. These findings support the use of noninvasive OCTA as a tool for early detection and monitoring of choroidal changes in diabetic eyes. |
| Key Words:
Choroid, Choroidal diseases, Diabetic retinopathy, Microcirculation, Optical coherence tomography |
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