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Review
. 2025 Jan 31;11(1):10.
doi: 10.1186/s40942-024-00618-5.

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

M Hossein Nowroozzadeh  1 , Mansoureh Bagheri  2   3
Affiliations
Review

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

M Hossein Nowroozzadeh et al. Int J Retina Vitreous. .

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.

Keywords: Choriocapillaris; Choroidal vasculature; Diabetic choroidopathy; Diabetic retinopathy; Optical coherence tomography angiography.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Shiraz University of Medical Sciences ethics committee (Shiraz, Iran) and was conducted in accordance with the ethical principles of the Declaration of Helsinki. Obtaining informed consent was not applicable to this study. Consent for publication: Obtaining consent for publication was not applicable to this study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Systematic review flow diagram on the role of optical coherence tomography angiography in assessing diabetic choroidopathy
See this image and copyright information in PMC

References

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