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Purpose <p>To investigate regional changes in choroidal vascular area (CVA) and choroidal vascular density (CVD) according to DR severity using stereographically corrected ultra-widefield (UWF) indocyanine green angiography (ICGA).</p> Methods <p>This retrospective cross-sectional study included 94 diabetic eyes and 20 control eyes. Diabetic eyes were categorized by DR severity using UWF fluorescein angiography. CVA and CVD were quantified from UWF ICGA images after stereographic projection and binarization to minimize peripheral distortion, and measurements were analyzed across concentric retinal regions from the macula to the far periphery.</p> Results <p>Both CVA and CVD showed progressive reductions with increasing DR severity, with the lowest values observed in proliferative DR (PDR) across all regions. Notably, in severe non-proliferative DR, CVD in the mid- and far-peripheral regions was reduced to levels comparable to those observed in PDR eyes. Multivariate linear regression analysis demonstrated that DR severity was independently and negatively associated with CVD in all concentric regions, whereas other ocular and systemic factors were not.</p> Conclusion <p>CVD was lower in more advanced stages of DR, with relatively greater involvement of the peripheral choroid. These findings suggest that UWF choroidal assessment may provide a potential complementary imaging biomarker for advanced DR.</p>

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Choroidal vascular alterations across diabetic retinopathy severity using ultra-widefield indocyanine green angiography

  • 期刊论文

  • 发表日期：

    2026年8月4日

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  • Areum Jeong,
  • Dong-Geun Park,
  • Jano van Hemert,
  • Min Sagong

摘要

Purpose

To investigate regional changes in choroidal vascular area (CVA) and choroidal vascular density (CVD) according to DR severity using stereographically corrected ultra-widefield (UWF) indocyanine green angiography (ICGA).

Methods

This retrospective cross-sectional study included 94 diabetic eyes and 20 control eyes. Diabetic eyes were categorized by DR severity using UWF fluorescein angiography. CVA and CVD were quantified from UWF ICGA images after stereographic projection and binarization to minimize peripheral distortion, and measurements were analyzed across concentric retinal regions from the macula to the far periphery.

Results

Both CVA and CVD showed progressive reductions with increasing DR severity, with the lowest values observed in proliferative DR (PDR) across all regions. Notably, in severe non-proliferative DR, CVD in the mid- and far-peripheral regions was reduced to levels comparable to those observed in PDR eyes. Multivariate linear regression analysis demonstrated that DR severity was independently and negatively associated with CVD in all concentric regions, whereas other ocular and systemic factors were not.

Conclusion

CVD was lower in more advanced stages of DR, with relatively greater involvement of the peripheral choroid. These findings suggest that UWF choroidal assessment may provide a potential complementary imaging biomarker for advanced DR.