In patients with diabetic retinopathy, age was the most robust determinant of CAVI, while LSFG-derived temporal peripapillary choroidal BOM (a resistance-related index) showed only a borderline positive trend, so the findings are exploratory and hypothesis-generating.
Key Findings
Results
In univariate analyses, higher systemic arterial stiffness (CAVI) was significantly associated with increased choroidal pulsatility and resistance in patients with diabetic retinopathy.
Retrospective cross-sectional study of 72 eyes from 72 patients with type 2 diabetes across DR stages.
Choroidal parameters measured by laser speckle flowgraphy (LSFG) were mean blur rate (MBR), beat strength (BS), and BS/MBR ratio (BOM) in temporal and nasal peripapillary regions.
The abstract reports that the univariate associations of CAVI with choroidal pulsatility and resistance were significant at P < 0.05.
Results
In the final exploratory stepwise multivariable model, age was significantly associated with higher CAVI.
Age: β = 0.048, P = 0.020.
Candidate predictors in the stepwise regression were age, sex, and LSFG parameters.
Age was described as the most robust determinant of CAVI in patients with DR.
Results
Temporal peripapillary choroidal BOM showed a borderline positive trend with CAVI in the final model, but did not reach conventional significance.
Temporal BOM: β = 2.719, P = 0.055.
Regional choroidal BOM parameters were retained in the final exploratory stepwise model.
The authors interpret this as a possible association whereby systemic pulsatile stress may influence choroidal hemodynamics.
Results
The final stepwise regression model for CAVI was statistically significant overall and explained about a third of the variance.
Adjusted R² = 0.326, P < 0.001.
The authors describe the analysis as exploratory and hypothesis-generating.
Conclusions
The authors conclude that LSFG-derived choroidal resistance (BOM) may help explore the ocular-systemic vascular connection in diabetes, with caveats about the exploratory nature of the findings.
The study design was retrospective and cross-sectional, limiting causal inference.
The sample was 72 patients with type 2 diabetes spanning DR stages.
Findings are described as hypothesis-generating.
What This Means
This study looked at whether stiffness of the body's arteries is linked to blood flow patterns in the choroid, the blood-vessel layer behind the retina, in people with diabetic eye disease. Researchers studied 72 people with type 2 diabetes. They measured arterial stiffness with a test called the cardio-ankle vascular index (CAVI) and measured choroidal blood flow, pulsation, and a resistance-related index with a laser speckle imaging technique.
When each measure was examined separately, stiffer arteries were associated with more pulsatile and higher-resistance blood flow in the choroid. When age, sex, and the eye measures were analyzed together, age was the clearest factor linked to arterial stiffness. A resistance-related eye measure in the temporal region near the optic nerve showed a possible link, but it fell just short of statistical significance.
This research suggests that eye blood-flow measurements might one day help reveal how the body's blood vessels are affected by diabetes. However, the study was small, looked at people at a single point in time, and was exploratory, so it cannot show cause and effect. Larger studies would be needed to confirm these findings.
Fujioka N, Tanaka K, Nunose M, Imai S, Takenaka R, Yagi F, et al.. (2026). Association Between Systemic Arterial Stiffness and Choroidal Vascular Resistance Assessed by Laser Speckle Flowgraphy in Diabetic Retinopathy.. Translational vision science & technology. https://doi.org/10.1167/tvst.15.10.41