Metabolic Status Modulates Choroidal Thickness – A Possible
                    Early Indicator for Diabetic Eye Complications?

Svenja Meyhöfer; Britta Wilms; Rodrigo Chamorro; Armin Knaak; Eleni Pappa; Agnetha S. Schulz; Anna-Josephin Pagels; Maria Schröder; Neele Kaluzny; Hans-Jürgen Grein; Sebastian M. Meyhöfer

doi:10.1055/a-1831-0265

Experimental and Clinical Endocrinology & Diabetes, Table of Contents

Exp Clin Endocrinol Diabetes 2022; 130(12): 789-792
DOI: 10.1055/a-1831-0265

Article

Metabolic Status Modulates Choroidal Thickness – A Possible Early Indicator for Diabetic Eye Complications?

Svenja Meyhöfer

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

²German Center for Diabetes Research, Neuherberg, Germany

³Department of Internal Medicine 1, Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

,

Britta Wilms

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

²German Center for Diabetes Research, Neuherberg, Germany

,

Rodrigo Chamorro

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

⁴Department of Nutrition, School of Medicine, University of Chile, Santiago, Chile

,

Armin Knaak

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

,

Eleni Pappa

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

²German Center for Diabetes Research, Neuherberg, Germany

³Department of Internal Medicine 1, Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

,

Agnetha S. Schulz

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

²German Center for Diabetes Research, Neuherberg, Germany

³Department of Internal Medicine 1, Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

,

Anna-Josephin Pagels

⁵Section of medical optics, Technische Hochschule Lübeck, Lübeck, Germany

,

Maria Schröder

⁵Section of medical optics, Technische Hochschule Lübeck, Lübeck, Germany

,

Neele Kaluzny

⁵Section of medical optics, Technische Hochschule Lübeck, Lübeck, Germany

,

Hans-Jürgen Grein

⁵Section of medical optics, Technische Hochschule Lübeck, Lübeck, Germany

,

Sebastian M. Meyhöfer

¹Institute for Endocrinology & Diabetes, University of Lübeck, Lübeck, Germany

²German Center for Diabetes Research, Neuherberg, Germany

› Author Affiliations

Abstract

Objective To investigate the impact of metabolic status on choroidal thickness (ChT) in healthy subjects, patients with obesity, and type 2 diabetes.

Design and Methods Fasting blood glucose, insulin, insulin-like growth factor-1 (IGF-1), and ChT measured by optical coherence tomography were assessed in healthy normal-weight (n=17), obese participants (n=20), and obese participants with T2D (n=16).

Results ChT increased in obese participants and obese participants with T2D as compared to healthy normal-weight participants (P<0.0001). A negative correlation was observed between IGF1 and ChT (r=−0.268, P=0.050) for all cohorts. Furthermore, body mass index (BMI; R²=0.209; P=0.002; beta=0.388) and model assessment-estimated insulin resistance (HOMA-IR; R²=0.074; P=0.015; beta=0.305) were independent variables of ChT, explaining 20.9 and 7.4% of its variance (both p<0.016), whereas age, sex, and IGF-1 were not significant confounders of ChT (p>0.975).

Conclusion ChT is associated with metabolic characteristics, i. e., BMI and HOMA-IR. Due to the key role of choroidal function in retinal physiology, future studies are needed to evaluate whether metabolic traits, ChT, and potential metabolic eye complications are mechanistically linked.

Full Text

References

References
1 Yau JWY, Rogers SL, Kawasaki R. et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012; 35: 556-564
2 Fong DS, Aiello L, Gardner TW. et al. Retinopathy in diabetes. Diabetes Care 2004; 27: S84-S87
3 Wu W-C, Shih C-P, Wang N-K. et al. Choroidal thickness in patients with a history of retinopathy of prematurity. JAMA Ophthalmol 2013; 131: 1451-1458
4 Tan K-A, Gupta P, Agarwal A. et al. State of science: Choroidal thickness and systemic health. Sur Ophthalmol 2016; 61: 566-581
5 Vujosevic S, Martini F, Cavarzeran F. et al. Macular and peripapillary choroidal thickness in diabetic patients. Retina 2012; 32: 1781-1790
6 Soubrane G. Macular Edema of Choroidal Origin. In: Coscas G, Loewenstein A, Cunha-Vaz J, et al., Hrsg. Developments in Ophthalmology. S. Karger AG. 2017: 202-219
7 Park K-A, Oh SY. Analysis of spectral-domain optical coherence tomography in preterm children: Retinal layer thickness and choroidal thickness profiles. Invest Ophthalmol Vis Sci 2012; 53: 7201-7207
8 Browning DJ, McOwen MD, Bowen RM. et al. Comparison of the clinical diagnosis of diabetic macular edema with diagnosis by optical coherence tomography. Ophthalmology 2004; 111: 712-715
9 Kim JT, Lee DH, Joe SG. et al. Changes in choroidal thickness in relation to the severity of retinopathy and macular edema in type 2 diabetic patients. Invest Ophthalmol Vis Sci 2013; 54: 3378
10 Unsal E, Eltutar K, Zirtiloglu S. et al. Choroidal thickness in patients with diabetic retinopathy. Clin Ophthalmol 2014; 637
11 American Diabetes Association. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes – 2019. Dia Care 2019; 42: S13-S28
12 Wang N-K, Lai C-C, Chu H-Y. et al. Classification of early dry-type myopic maculopathy with macular choroidal thickness. Am J Ophthalmol 2012; 153: 669-677 677.e1-2
13 Matthews DR, Hosker JP, Rudenski AS. et al. Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419
14 Xu J, Xu L, Du KF. et al. Subfoveal choroidal thickness in diabetes and diabetic retinopathy. Ophthalmology 2013; 120: 2023-2028
15 Lee YJ, Lee YJ, Lee JY. et al. A pilot study of scleral thickness in central serous chorioretinopathy using anterior segment optical coherence tomography. Sci Rep 2021; 11: 5872
16 Jo Y, Ikuno Y, Iwamoto R. et al. Choroidal thickness changes after diabetes type 2 and blood pressure control in a hospitalized situation. Retina 2014; 34: 1190-1198
17 Tavares Ferreira J, Vicente A, Proença R. et al. Choroidal thickness in diabetic patients without diabetic retinopathy. Retina 2018; 38: 795-804
18 Hřebíček J, Janout V, Malinčíková J. et al. Detection of insulin resistance by simple Quantitative Insulin Sensitivity Check Index QUICKI for epidemiological assessment and prevention. J Clin Endocrinol Metab 2002; 87: 144-144
19 Singh B, Saxena A. Surrogate markers of insulin resistance: A review. World J Diabetes 2010; 1: 36-47
20 Motamed N, Miresmail SJH, Rabiee B. et al. Optimal cutoff points for HOMA-IR and QUICKI in the diagnosis of metabolic syndrome and non-alcoholic fatty liver disease: A population based study. J Diabetes Complications 2016; 30: 269-274
21 Berryman DE, Glad CAM, List EO. et al. The GH/IGF-1 axis in obesity: Pathophysiology and therapeutic considerations. Nat Rev Endocrinol 2013; 9: 346-356
22 Sandhu MS, Heald AH, Gibson JM. et al. Circulating concentrations of insulin-like growth factor-I and development of glucose intolerance: A prospective observational study. Lancet 2002; 359: 1740-1745
23 Haywood NJ, Slater TA, Matthews CJ. et al. The insulin like growth factor and binding protein family: Novel therapeutic targets in obesity & diabetes. Mol Metab 2019; 19: 86-96
24 Teppala S, Shankar A. Association between serum IGF-1 and diabetes among U.S. adults. Diabetes Care 2010; 33: 2257-2259
25 Burgos R, Mateo C, Cantón A. et al. Vitreous levels of IGF-I, IGF binding protein 1, and IGF binding protein 3 in proliferative diabetic retinopathy: A case-control study. Diabetes Care 2000; 23: 80-83
26 Wei WB, Xu L, Jonas JB. et al. Subfoveal choroidal thickness: The Beijing Eye Study. Ophthalmology 2013; 120: 175-180